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Myopericarditis following mRNA COVID-19 vaccination in adolescents 12 through 18 years of age


The aim of the study was to characterize the clinical course and outcomes of children who developed probable myopericarditis after vaccination with the Pfizer- BioNTech ( BNT162b2 ) COVID-19 mRNA vaccine.

A cross-sectional study of 32 children, aged 12 through 18 years, diagnosed with probable myopericarditis following COVID-19 mRNA vaccination as per the CDC criteria for myopericarditis was carried out at 9 US centers between May 10, 2021 and June 20, 2021.

Researchers have retrospectively collected the following data: demographics, SARS-CoV-2 virus detection or serologic testing, clinical manifestations, laboratory test results, imaging study results, treatment and time to resolutions of symptoms.

Most ( 90% ) cases followed the second dose of vaccine, and chest pain ( 100% ) was the most common presenting symptom.
Patients came to medical attention a median of 2 days ( range: less than 1-20 days ) after receipt of Pfizer mRNA COVID-19 vaccination.

All adolescents had an elevated plasma troponin concentration.

Echocardiographic abnormalities were infrequent, and 84% showed normal cardiac function at presentation.
However, cardiac magnetic resonance imaging ( CMR ), obtained in 16 patients ( 50% ), revealed that 15 ( 94% ) had late Gadolinium enhancement consistent with myopericarditis.

Most were treated with Ibuprofen or an equivalent nonsteroidal anti-inflammatory drugs ( NSAID ) for symptomatic relief, one patient was treated primarily with a corticosteroid orally and three patients were given a corticosteroid orally after initial administration of Ibuprofen or NSAID; two patients also received intravenous immune globulin.
Symptom resolution was observed within 7 days in all patients.

In conclusion, the data have suggested that symptoms due to myopericarditis following mRNA COVID-19 vaccination tend to be mild and transient.
Approximately one half of patients underwent magnetic resonance imaging, which revealed evidence of myocardial inflammation despite a lack of echocardiographic abnormalities. ( Xagena )

Das BB, J Pediatr 2021; Online ahead of print

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