COVID-19 vaccination and cardiac dysfunction

摘要

The coronavirus disease 2019(COVID-19)mRNA vaccine against severe acute respiratory syndrome coronavirus 2 infections has reduced the number of symptomatic patients globally.A case series of vaccine-related myocarditis or pericarditis has been published with extensive vaccination,most notably in teenagers and young adults.Men seem to be impacted more often,and symptoms commonly occur within 1 wk after immunization.The clinical course is mild in the majority of cases.Based on the evidence,a clinical framework to guide physicians to examine,analyze,identify,and report suspected and confirmed cardiac dysfunction cases is needed.A standardized workup for every patient with strongly suspicious symptoms associated with the COVID-19 mRNA vaccine comprises serum cardiac troponin measurement and a 12-lead electrocardiogram(ECG).For patients with unexplained elevation of cardiac troponin and pathologic ECG,echocardiography is recommended.Consultation with a cardiovascular expert and hospitalization should be considered in this group of patients.Treatment is primarily symptomatic and supportive.Deferring a 2^(nd) dose of the COVID-19 mRNA vaccination in individuals with suspected myocarditis or pericarditis after the 1^(st) dose is suggested until further safety data become available.