Study: COVID vaccine-related myocarditis mild, resolves quickly
Today in Circulation, researchers report that most cases of rare yet potentially serious episodes of myocarditis related to COVID-19 vaccinations in teens and young adults were mild, and the case-patients recovered quickly.
Myocarditis, an inflammation of the heart muscle, often follows bacterial or viral infections. In June 2021, the US Centers for Disease Control and Prevention reported a link between mRNA COVID-19 vaccines and increased incidents of myocarditis, especially in boys and men 12 to 29.
In this study, researchers analyzed data on 139 cases of myocarditis in young adults and teens ages 12 to 20, reviewing medical records from 26 pediatric medical centers in the United States and Canada. They included myocarditis cases within 1 month of vaccination.
The authors found that myocarditis usually began within 2 days of vaccine administration of the second dose of mRNA vaccine, and 99.3% of patients reported chest pain, while 30.9% reported fever.
No patients died, but one in five patients (18.7%) required intensive care unit hospitalization, for an average of 2 to 3 days. Three fourths (77.3%) of patients who received cardiac imaging showed evidence of inflammation of or injury to the heart muscle, and 18.7% had at least mildly decreased left ventricular function at presentation, but heart function had returned to normal in all who returned for follow-up, the authors said.
"These data suggest that most cases of suspected COVID-19 vaccine-related myocarditis in people younger than 21 are mild and resolve quickly," said study author Dongngan T. Truong, MD, a pediatric cardiologist at Intermountain Primary Children's Hospital in Salt Lake City, in an American Heart Association (AHA) press release.
Dec 6 Circulation study
Dec 6 AHA press release
Hispanic race, diabetes, poverty tied to higher rates TB plus COVID-19
Tuberculosis (TB) and COVID-19 were disproportionately diagnosed in close succession and more than twice as likely to lead to death among Californians who were Hispanic, had diabetes, or lived in areas of low health equity than those diagnosed as having TB before the pandemic, finds a study published late last week in JAMA Network Open.
Researchers from California public health departments and the Centers for Disease Control and Prevention (CDC) examined state health surveillance records for residents diagnosed as having TB from Sep 3, 2019, to Dec 31, 2020, and COVID-19 up to Feb 2, 2021, and compared them with those diagnosed as having TB from Jan 1, 2017, to Dec 31, 2019, or COVID-19 alone until Feb 2, 2021.
Included in the analysis were 3,402,713 Californians who had COVID-19 alone, 6,280 who had TB before the pandemic, and 91 diagnosed as having COVID-19 within 120 days of a TB diagnosis. Among the latter group, median age was 58.0 years, 57.1% were men, 89.0% were born outside of the United States, 60.4% were Hispanic, 30.8% were Asian or Pacific Islander, 4.4% were Black, and 4.4% were White.
In Californians who received a TB diagnosis from Sep 3, 2019, to Dec 31, 2020, the rate of COVID-19 infection was 10.2%, which was similar to that in the rest of the state (8.6%). Relative to residents who had TB before the pandemic, those with TB and COVID-19 were more likely to be Hispanic (60.4% vs 36.4%), live in a census tract with low health equity (44.9% vs 32.9%), have lived in the United States longer before receiving a TB diagnosis (median, 23.1 vs 19.7 years), and have diabetes (46.2% vs 27.6%).
The death rate among Californians with both TB and COVID-19 diagnosed within 30 days of each other was more than twice as high as those diagnosed with TB before the pandemic (23.5% vs 11.4%) and 20 times higher than in those with COVID-19 alone (1.2%). People with TB and COVID-19 who died were older than those who survived (median, 81.0 vs 54.0 years).
"Addressing health inequities and integrating prevention efforts could avert the occurrence of concurrent COVID-19 and TB and potentially reduce deaths," the study authors wrote.
Dec 3 JAMA Netw Open study