COVID-19 vaccine-associated myocarditis  

作　　者：Michael C Morgan Lavannya Atri Sean Harrell Wael Al-Jaroudi Adam Berman 

机构地区：[1]Division of Cardiology,Medical College of Georgia,Augusta,GA 30912,United States [2]Baptist Heart,Baptist Medical Center,Jackson,MS 39202,United States [3]Department of Population Health Sciences,Medical College of Georgia,Augusta,GA 30912,United States

出　　处：《World Journal of Cardiology》2022年第7期382-391,共10页世界心脏病学杂志（英文版）（电子版）

摘　　要：Myocarditis is now recognized as a rare complication of coronavirus disease 2019(COVID-19)mRNA vaccination,particularly in adolescent and young adult males.Since the authorization of the Pfizer-BioNTech^(TM)and Moderna^(TM)mRNA vaccines targeting the severe acute respiratory syndrome coronavirus-2(SARSCoV-2)spike protein,the Centers for Disease Control and Prevention(CDC)has reported 1175 confirmed cases of myocarditis after COVID-19 vaccination in individuals ages 30 years and younger as of January 2022.According to CDC data in June 2021,the incidence of vaccine-mediated myocarditis in males ages 12-29 years old was estimated to be 40.6 cases per million second doses of COVID-19 mRNA vaccination administered.Individuals with cases of COVID-19 vaccinemediated myocarditis typically present with acute chest pain and elevated serum troponin levels,often within one week of receiving the second dose of mRNA COVID-19 vaccination.Most cases follow a benign clinical course with prompt resolution of symptoms.Proposed mechanisms of COVID-19 vaccine myocarditis include molecular mimicry between SARS-CoV-2 spike protein and self-antigens and the triggering of preexisting dysregulated immune pathways in predisposed individuals.The higher incidence of COVID-19 vaccine myocarditis in young males may be explained by testosterone and its role in modulating the immune response in myocarditis.There is limited data on long-term outcomes in these cases given the recency of their occurrence.The CDC continues to recommend COVID-19 vaccination for everyone 5 years of age and older given the greater risk of serious complications related to natural COVID-19 infection including hospitalization,multisystem organ dysfunction,and death.Further study is needed to better understand the immunopathology and long-term outcomes behind COVID-19 mRNA vaccine-mediated myocarditis.

关 键 词：COVID-19 SARS-CoV-2 mRNA vaccine MYOCARDITIS PERICARDITIS 

分 类 号：R186[医药卫生—流行病学] R542.2[医药卫生—公共卫生与预防医学]