Risk of myocarditis and pericarditis in mRNA COVID-19-vaccinated and unvaccinated populations: a systematic review and meta-analysis

• Autores: Alami, Abdallah; Krewski, Daniel; Farhat, Nawal; Mattison, Donald; Wilson, Kumanan; Gravel, Christopher A.; Farrell, Patrick J.; Crispo, James A. G.; Pérez Lloret, Santiago; Villeneuve, Paul J.; Haddad, Nisrine
• Año de publicación: 2023
• Idioma: inglés
• Tipo de recurso: artículo
• Fuente: BMJ Open Vol.13, No.6: e065687, 2023
• Materia: COVID-19; EPIDEMIOLOGIA; SALUD PUBLICA.; MIOCARDITIS; PERICARDITIS
• Institución: Pontificia Universidad Católica Argentina

Fil: Alami, Abdallah. Carleton University. School of Mathematics and Statistics. Faculty of Science; Canadá
Fil: Krewski, Daniel. University of Ottawa. School of Epidemiology and Public Health. Faculty of Medicine; Canadá
Fil: Krewski, Daniel. Risk Sciences International; Canadá
Fil: Farhat, Nawal. Carleton University. School of Mathematics and Statistics. Faculty of Science; Canadá
Fil: Mattison, Donald. University of Ottawa. School of Epidemiology and Public Health. Faculty of Medicine; Canadá
Fil: Mattison, Donald. Risk Sciences International; Canadá
Fil: Mattison, Donald. University of South Carolina. Arnold School of Public Health; Estados Unidos
Fil: Wilson, Kumanan. University of Ottawa. Bruyère Research Institute; Canadá
Fil: Wilson, Kumanan. Ottawa Hospital Research Institute; Canadá
Fil: Gravel, Christopher A. University of Ottawa. School of Epidemiology and Public Health. Faculty of Medicine; Canadá
Fil: Gravel, Christopher A. Risk Sciences International; Canadá
Fil: Farrell, Patrick J. Carleton University. School of Mathematics and Statistics. Faculty of Science; Canadá
Fil: Crispo, James A. G. The University of British Columbia. Faculty of Pharmaceutical Sciences; Canadá
Fil: Crispo, James A. G. University of Northern Ontario School of Medicine. Division of Human Sciences; Canadá
Fil: Haddad, Nisrine. University of Ottawa. School of Epidemiology and Public Health. Faculty of Medicine; Canadá
Fil: Haddad, Nisrine. Risk Sciences International; Canadá
Fil: Pérez Lloret, Santiago. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Pérez Lloret, Santiago. Pontificia Universidad Católica Argentina. Observatorio de Salud Pública; Argentina
Fil: Pérez Lloret, Santiago. Universidad de Buenos Aires. Facultad de Medicina, Departamento de Fisiología; Argentina
Fil: Villeneuve, Paul J. Carleton University. Faculty of Science. Department of Neurosciences; Canadá
Abstract: Objective To summarise the available evidence on the risk of myocarditis and/or pericarditis following mRNA COVID-19 vaccination, compared with the risk among unvaccinated individuals in the absence of COVID-19 infection. Design Systematic review and meta-analysis. Data sources Electronic databases (Medline, Embase, Web of Science and WHO Global Literature on Coronavirus Disease), preprint repositories (medRxiv and bioRxiv), reference lists and grey literature were searched from 1 December 2020 until 31 October 2022. Study selection Epidemiological studies of individuals of any age who received at least one dose of an mRNA COVID-19 vaccine, reported a risk of myo/pericarditis and compared the risk of myo/pericarditis to individuals who did not receive any dose of an mRNA COVID-19 vaccine. Data extraction and synthesis Two reviewers independently conducted screening and data extraction. The rate of myo/pericarditis among vaccinated and unvaccinated groups was recorded, and the rate ratios were calculated. Additionally, the total number of individuals, case ascertainment criteria, percentage of males and history of SARS-CoV-2 infection were extracted for each study. Meta-analysis was done using a randomeffects model. Results Seven studies met the inclusion criteria, of which six were included in the quantitative synthesis. Our metaanalysis indicates that within 30-day follow-up period, vaccinated individuals were twice as likely to develop myo/pericarditis in the absence of SARS-CoV-2 infection compared to unvaccinated individuals, with a rate ratio of 2.05 (95% CI 1.49–2.82). Conclusion Although the absolute number of observed myo/pericarditis cases remains quite low, a higher risk was detected in those who received mRNA COVID-19 vaccinations compared with unvaccinated individuals in the absence of SARS-CoV-2 infection. Given the effectiveness of mRNA COVID-19 vaccines in preventing severe illnesses, hospitalisations and deaths, future research should focus on accurately determining the rates of myo/pericarditis linked to mRNA COVID-19 vaccines, understanding the biological mechanisms behind these rare cardiac events and identifying those most at risk.