Table 1.
Clinical and laboratory summary of the study population.
| No. | Age/sex/ Time of presentation | ECG | Peak CRP* Peak Troponin-T*Serology**RT-PCR *** | COVID-19 status1. RT-PCR2. nucleocapsid antibodies3.Spike protein antibodies | TTE | Coronary imaging | Cardiac MRI |
|---|---|---|---|---|---|---|---|
| Case 1 | 24 y, male,72 h after receiving the2nd dose of the vaccine | Diffuse ST elevation Inverted T lead III | CRP - 58.1 mg/L;Troponin T - 589 ng/L;Serology – negativeRT-PCR - negative | 1.negative2.negative3.positive | Normal study | NA | T2 sequence showed mild myocardial edema of the basal septum and inferolateral wall.Subepicardial and mid myocardial LGE of the same affected segments |
| Case 2 | 20 y, male,24 h after 2nd vaccine | Sinus tachycardiaST elevation V2-6 | 100.0 mg/lTroponin T - 1062 ng/lSerology – negativeRT-PCR- negative | 1.negative2.negative3.positive | LVEF-50-55%Apical hypokinesis | CT Angiography: NCA | T2 sequence showed mild myocardial edema with LGE in the subepicardial region of the basal and middle anterolateral and inferolateral walls |
| Case 3 | 29 y, male,48 h after receiving the 2nd dose of the vaccine | Diffuse PR depressionDiffuse ST elevation | CRP - 86.0 mg/LTroponin T - 876 ng/LSerology – negativeRT-PCR- negative | 1.negative2.negative3.positive | Normal study | NA | T2 sequences showed mild diffuse myocardial edemaand LGE of the basal, inferolateral, anterolateral and anteroseptal walls |
| Case 4 | 45 y, male,16 days after receiving the1st dose of the vaccine | ST elevation: I, aVL, V3-5Inverted T, ST depression:III, aVF | CRP - 56.2 mg/LTroponin T - 392 ng/LSerology – negativeRT-PCR- negative | 1.negative2.negative3.positive | LVEF-50-55% | Coronary angiogram:NCA | LVEF 50-55%T2 sequence showed subepicardial edema of the middle anterolateral, inferolateral and of the apical anterior walls with LGE of the affected walls |
| Case 5 | 16 y, male24 h after receiving the2nd dose of the vaccine | ST elevation V2-4 | CRP -1.6 mg/L Hs troponin-I 14350 ng/LSerology – negativeRT-PCR- negative | 1.negative2. nonreactive3. positive | Normal study | NA | Normal LV size LVEF 59%T2 sequence show midmyocardial and subepicardial edema of the basal inferolateral and middle anterolateral segments. LGE present in the same segments |
| Case 6 | 17 y, male72 h after receiving the 2nd dose of the vaccine | ST elevation I II aVL, V2-6SI QIII TIII | CRP - 54.7 mg/LTroponin T 1130 ng/LSerology - negativeRT-PCR - negative | 1.Negative2.Nonreactive3.positive | Normal study | NA | T2 sequence showed subepicardial edema of the basal inferolateral, middle inferolateral and infero-septal and apical lateral, anterior and inferior walls. LGE present in the same segments and mid-myocardial enhancement of the middle inferolateral and anterolateral and apical anterior and lateral walls. Findings consistent with myo-pericarditis. |
ECG - electrocardiography; EF - Ejection Fraction; TTE - transthoracic echocardiography; NA - not assessed; NCA - normal coronary arteries; LV - Left Ventricle; LGE - late gadolinium enhancement.
* Serum C-reactive protein (CRP) level (normal range (0.0–5.0 mg/L); serum troponin T level (normal range 0.0–13.0 ng/L; Above 50 – positive).
** Serology: Epstein-Barr virus (EBV), cytomegalovirus (CMV), hepatitis B virus (HBV), Coxsackie viruses, parvovirus B19, Coxiella burnetii, Mycoplasma pneumoniae.
*** RT-PCR: adenovirus, parainfluenza, respiratory syncytial virus (RSV), influenza A virus, influenza B virus, enterovirus, human metapneumovirus, Bordetella pertussis, Bordetella parapertussis, Chlamydia pneumoniae, Mycoplasma pneumoniae.