与 COVID-19 疫苗接种相关的心包炎：韩国全国性研究

IF 6.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

Mayo Clinic proceedings Pub Date : 2024-10-01 DOI:10.1016/j.mayocp.2024.03.026

Nuri Lee MD , Kye Hun Kim MD, PhD , Jae-Hyeong Park MD, PhD , Jae Yeong Cho MD, PhD , Soo Hyeon Cho MPH , Dong Keun Kim MD , Seung Yun Kim MD , Eun Kyoung Kim MS , Eui-Young Choi MD, PhD , Jin-Oh Choi MD, PhD , Suji Cho MD , Ga Hui Choi MD , Hyukjin Park MD, PhD , Hyung Yoon Kim MD, PhD , Hyun Ju Yoon MD, PhD , Youngkeun Ahn MD, PhD , Myung Ho Jeong MD, PhD

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引用次数: 0

摘要

摘要为了调查不伴有心肌炎的 COVID-19 疫苗相关心包炎 (VRP) 的发病率、特征和结果，我们分析了韩国全国范围内的数据：这是一份全国范围内的回顾性报告，包括2021年2月26日至12月31日期间所有接种过任何平台（BNT162b2、mRNA-1273、ChAdOx1或Ad26.COV2.S）COVID-19疫苗的韩国人。我们对专家评审委员会确认的 COVID-19 VRP 病例进行了分析。我们对 COVID-19 VRP 的发病率、临床特征和结果进行了分析：结果：在接种过至少一剂 COVID-19 疫苗的 44,322,068 名韩国人中，有 179 例确诊了 COVID-19 VRP，每百万针中有 1.73 例（95% CI，每百万针中有 1.48 至 2.00 例）。男性的 VRP 发生率明显高于女性（分别为每 100 万剂 2.01 例与每 100 万剂 1.45 例；P=.029），mRNA 疫苗的 VRP 发生率明显高于其他疫苗（分别为每 100 万剂 2.09 例与每 100 万剂 0.36 例；P=.029）：COVID-19 VRP非常罕见，主要与mRNA疫苗有关，尤其是40岁以下的男性。VRP 的临床病程良好，无死亡病例。不过，应仔细观察是否出现血流动力学意义上的心包积液。

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COVID-19 Vaccination–Related Pericarditis

Objective

To investigate the incidence, characteristics, and outcomes of COVID-19 vaccine–related pericarditis (VRP) without myocarditis, we analyzed nationwide Korean data.

Patients and Methods

This is a retrospective nationwide report including all vaccinated Koreans with COVID-19 vaccine of any platform (BNT162b2, mRNA-1273, ChAdOx1, or Ad26.COV2.S) from February 26 to December 31, 2021. We analyzed the confirmed cases of COVID-19 VRP by the Expert Adjudication Committee. The incidence, clinical characteristics, and outcomes of COVID-19 VRP were analyzed.

Results

Among 44,322,068 Koreans with least one dose of COVID-19 vaccination, COVID-19 VRP was confirmed in 179 cases, with 1.73 per million shots (95% CI, 1.48 to 2.00 per million shots). The incidence of VRP was significantly higher in males than females (2.01 per 1 million doses vs 1.45 per 1 million doses, respectively; P=.029), in mRNA vaccines than in other vaccines (2.09 per 1 million doses vs 0.36 per 1 million doses, respectively; P<.001), and in those younger than 40 years of age than those older than 40 years of age (3.52 per 1 million doses vs 0.89 per 1 million doses, respectively; P<.001). The incidence of VRP was highest in males between the ages of 12 and 17 years (7.38 per 1 million doses; 95% CI, 2.01 to 16.07). Although there was no case of mortality, hemodynamically significant pericardial effusion requiring pericardial drainage was noted in 10 cases (5.6%).

Conclusion

COVID-19 VRP was very rare and developed mainly in association with mRNA vaccines, especially in males younger than 40 years of age. The clinical course of VRP was excellent, and there were no cases of mortality. However, the development of hemodynamically significant pericardial effusion should be carefully monitored.

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来源期刊

Mayo Clinic proceedings 医学-医学：内科

CiteScore

16.80

自引率

1.10%

发文量

383

审稿时长

37 days

期刊介绍： Mayo Clinic Proceedings is a premier peer-reviewed clinical journal in general medicine. Sponsored by Mayo Clinic, it is one of the most widely read and highly cited scientific publications for physicians. Since 1926, Mayo Clinic Proceedings has continuously published articles that focus on clinical medicine and support the professional and educational needs of its readers. The journal welcomes submissions from authors worldwide and includes Nobel-prize-winning research in its content. With an Impact Factor of 8.9, Mayo Clinic Proceedings is ranked #20 out of 167 journals in the Medicine, General and Internal category, placing it in the top 12% of these journals. It invites manuscripts on clinical and laboratory medicine, health care policy and economics, medical education and ethics, and related topics.