| Verf.angabe: | Nele Rolfs, MD,Cynthia Huber, MSc, Eicke Schwarzkopf, MA, Dirk Mentzer, MD, Brigitte Keller-Stanislawski, MD, Bernd Opgen-Rhein, MD, Wiebke Frede, MD, Axel Rentzsch, MD, Tobias Hecht, MD, Martin Boehne, MD, PhD, Maria Grafmann, MD, Daniela Kiski, MD, Iva Graumann, MD, Rudi Foth, MD, Inga Voges, MD, PhD, Ulrich Schweigmann, MD, Bettina Ruf, MD, Marcus Fischer, MD, Gesa Wiegand, MD, Karin Klingel, MD, PhD, Thomas Pickardt, PhD, Tim Friede, PhD, Daniel Messroghli, MD, PhD, Stephan Schubert, MD, PhD, and Franziska Seidel, MD, on Behalf of the MYKKE Consortium |
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| Abstract: | Background: Since the onset of widespread COVID-19 vaccination, increased incidence of COVID-19 vaccine-associated myocarditis (VA-myocarditis) has been noted, particularly in male adolescents. Methods: Patients <18 years with suspected myocarditis following COVID-19 vaccination within 21 days were enrolled in the PedMYCVAC cohort, a substudy within the prospective multicenter registry for pediatric myocarditis “MYKKE.” Clinical data at initial admission, 3- and 9-months follow-up were monitored and compared to pediatric patients with confirmed non–vaccine-associated myocarditis (NVA-myocarditis) adjusting for various baseline characteristics. Results: From July 2021 to December 2022, 56 patients with VA-myocarditis across 15 centers were enrolled (median age 16.3 years, 91% male). Initially, 11 patients (20%) had mildly reduced left ventricular ejection fraction (LVEF; 45%-54%). No incidents of severe heart failure, transplantation or death were observed. Of 49 patients at 3-months follow-up (median (IQR) 94 (63-118) days), residual symptoms were registered in 14 patients (29%), most commonly atypical intermittent chest pain and fatigue. Diagnostic abnormalities remained in 23 patients (47%). Of 21 patients at 9-months follow-up (259 (218-319) days), all were free of symptoms and diagnostic abnormalities remained in 9 patients (43%). These residuals were mostly residual late gadolinium enhancement in magnetic resonance imaging. Patients with NVA-myocarditis (n=108) more often had symptoms of heart failure (P = .003), arrhythmias (P = .031), left ventricular dilatation (P = .045), lower LVEF (P < .001) and major cardiac adverse events (P = .102).Conclusions: Course of COVID-19 vaccine-associated myocarditis in pediatric patients seems to be mild and differs from non–vaccine-associated myocarditis. Due to a considerable number of residual symptoms and diagnostic abnormalities at follow-up, further studies are needed to define its long-term implications. |
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