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Open Access 30-07-2022 | COVID-19 | Original Paper

COVID-19 vaccination and carditis in children and adolescents: a systematic review and meta-analysis

Authors: Oscar Hou In Chou, Jonathan Mui, Cheuk To Chung, Danny Radford, Simon Ranjithkumar, Endurance Evbayekha, Ronald Nam, Levent Pay, Danish Iltaf Satti, Sebastian Garcia-Zamora, George Bazoukis, Göksel Çinier, Sharen Lee, Vassilios S. Vassiliou, Tong Liu, Gary Tse, Ian Chi Kei Wong, Oscar Hou In Chou, Tong Liu, Gary Tse, the Cardiovascular Analytics Group, the International Health Informatics Study Network

Published in: Clinical Research in Cardiology | Issue 10/2022

Abstract

Background

Coronavirus Disease-2019 (COVID-19) vaccination has been associated with the development of carditis, especially in children and adolescent males. However, the rates of these events in the global setting have not been explored in a systematic manner. The aim of this systematic review and meta-analysis is to investigate the rates of carditis in children and adolescents receiving COVID-19 vaccines.

Methods

PubMed, Embase and several Latin American databases were searched for studies. The number of events, and where available, at-risk populations were extracted. Rate ratios were calculated and expressed as a rate per million doses received. Subgroup analysis based on the dose administered was performed. Subjects ≤ 19 years old who developed pericarditis or myocarditis following COVID-19 vaccination were included.

Results

A total of 369 entries were retrieved. After screening, 39 articles were included. Our meta-analysis found that 343 patients developed carditis after the administration of 12,602,625 COVID-19 vaccination doses (pooled rate per million: 37.76; 95% confidence interval [CI] 23.57, 59.19). The rate of carditis was higher amongst male patients (pooled rate ratio: 5.04; 95% CI 1.40, 18.19) and after the second vaccination dose (pooled rate ratio: 5.60; 95% CI 1.97, 15.89). In 301 cases of carditis (281 male; mean age: 15.90 (standard deviation [SD] 1.52) years old) reported amongst the case series/reports, 261 patients were reported to have received treatment. 97.34% of the patients presented with chest pain. The common findings include ST elevation and T wave abnormalities on electrocardiography. Oedema and late gadolinium enhancement in the myocardium were frequently observed in cardiac magnetic resonance imaging (CMR). The mean length of hospital stay was 3.91 days (SD 1.75). In 298 out of 299 patients (99.67%) the carditis resolved with or without treatment.

Conclusions

Carditis is a rare complication after COVID-19 vaccination across the globe, but the vast majority of episodes are self-limiting with rapid resolution of symptoms within days.

Graphical abstract

Central illustration. Balancing the benefits of vaccines on COVID-19-caused carditis and post-vaccination carditis.

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World Health Organization (2022) WHO COVID-19 Dashboard. https://covid19.who.int/

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Title: COVID-19 vaccination and carditis in children and adolescents: a systematic review and meta-analysis
Authors: Oscar Hou In Chou
Jonathan Mui
Cheuk To Chung
Danny Radford
Simon Ranjithkumar
Endurance Evbayekha
Ronald Nam
Levent Pay
Danish Iltaf Satti
Sebastian Garcia-Zamora
George Bazoukis
Göksel Çinier
Sharen Lee
Vassilios S. Vassiliou
Tong Liu
Gary Tse
Ian Chi Kei Wong
Oscar Hou In Chou
Tong Liu
Gary Tse
the Cardiovascular Analytics Group, the International Health Informatics Study Network
Publication date: 30-07-2022
Publisher: Springer Berlin Heidelberg
Keywords: COVID-19
Myocarditis
COVID-19 Vaccination
Vaccination
COVID-19
Published in: Clinical Research in Cardiology / Issue 10/2022
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-022-02070-7

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