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