Table 1.
Literature review of demographic and clinical characteristics of patients with myocarditis following various COVID-19 vaccination, December 2020 to July 4, 2021.a
| Publication |
Montgomery et al. [12] |
Larson & Ammirati et al. [22] |
Rosner et al. [17] |
Marshall et al. [23] |
Mouch et al. [24] |
Dickey et al. [25] |
Kim et al. [26] |
Mansour et al. [27] |
|---|---|---|---|---|---|---|---|---|
| Characteristic | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) |
| Age, median (range), y | 25 (20–51) | 29 (21–56) | 24 (19–39) | 17 (14–19) | 23 (16–45) | (17–37) | 30 (23–70) | 23 (21–25) |
| Sex | ||||||||
| Male | 23 (100) | 8 (100) | 7 (100) | 7 (100) | 6 (100) | 6 (100) | 3 (75) | 1 (50) |
| Female | 0 | 0 | 0 | 0 | 0 | 0 | 1 (25) | 1 (50) |
| Proximate vaccine dose | ||||||||
| Second mRNA-1273 dose | 14 (61) | 2 (25) | 1 (14) | 0 | 0 | 2 (33) | 2 (50) | 2 (100) |
| Second BNT162b2-mRNA dose | 6 (26) | 6 (75) | 4 (57) | 7 (100) | 5 (83) | 4 (67) | 2 (50) | 0 |
| First mRNA-1273 dose | 2 (9) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| First BNT162b2-mRNA dose | 1 (4) | 1 | 1 (14) | 0 | 1 (17) | 0 | 0 | 0 |
| Single Ad.26.COV2.S dose | 0 | 0 | 1 (14) | 0 | 0 | 0 | 0 | 0 |
| Time to symptom onset, mean (range), h | 50 (12–96) | 66 (48–96) | 93 (48–168) | 62 (48–96) | 104 (24–384) | 80 (48–96) | 66 (24–100) | 39 (30–48) |
| Troponin level | ||||||||
| Elevated | 23 (100) | 8 (100) | 7 (100) | 7 (100) | 6 (100) | 6 (100) | 4 (100) | 2 (100) |
| Not elevated | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Electrocardiogram findingsb | ||||||||
| Abnormal | 19 (83) | 7 (88) | 5 (72) | 7 (100) | 6 (100) | 5 (83) | 4 (100) | 2 (100) |
| Normal | 4 (17) | 1 (12) | 2 (28) | 0 | 0 | 1 (17) | 0 | 0 |
| Echocardiogram findingsc | ||||||||
| LVEF <50% | 4 (17) | 2 (25) | 1 (14) | 1 (14) | 0 | 5 (83) | 1 (25) | 0 |
| LVEF ≥50% | 19 (83) | 6 (75) | 6 (86) | 6 (86) | 6 (100) | 1 (17) | 3 (75) | 2 (100) |
| Coronary artery imagingd | ||||||||
| Abnormal | 0 | 0 | 0 | 0 | NR | 0 | 0 | |
| Normal | 16 (70) | 5 (62) | 3 (43) | 0 | 2 (33) | NR | 1 (25) | 2 (100) |
| Not performed | 7 (30) | 3 (38) | 4 (57) | 7 (100) | 4 (67) | NR | 3 (75) | 0 |
| Cardiac MRIe | ||||||||
| Abnormal | 8 (35) | 8 (100) | 7 (100) | 7 (100) | 6 (100) | 6 (100) | 4 (100) | 2 (100) |
| Normal | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Not performed | 15 (65) | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| SARS-CoV-2 PCR findings at presentation | ||||||||
| Positive | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Negative | 19 (83) | 8 (100) | 6 (86) | 7 (100) | 6 (100) | 6 (100) | 3 (75) | 2 (100) |
| Not performed | 4 (17) | 0 | 1 (14) | 0 | 0 | 1 (25) | 0 | |
| Other viral testing at presentationf | ||||||||
| Positive | 0 | NR | 0 | 0 | NR | NR | 0 | 0 |
| Negative | 13 (57) | NR | 5 (72) | 7 (100) | NR | NR | 4 (100) | 2 (100) |
| Not performed | 10 (43) | NR | 2 (28) | 0 | NR | NR | 0 | 0 |
| History of prior SARS-CoV-2 infection | ||||||||
| Positive | 3 (13) | 1 (12) | 3 (43) | 0 | 0 | NR | 0 | 0 |
| Negative | 20 (87) | 7 (88) | 4 (57) | 6 (86) | 6 (100) | NR | 4 (100) | 2 (100) |
| Unknown | 0 | 0 | 0 | 1 (14) | 0 | NR | 0 | 0 |
| Publication |
D'Angelo et al. [28] |
Habib et al. [29] |
Muthukumar et al. [30] |
Shaw et al. [31] |
Nevet et al. [32] |
Vidula et al. [33] |
Park et al. [34] |
Ammirati et al. [35] |
|---|---|---|---|---|---|---|---|---|
| Characteristic | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) |
| Age, median (range), y | 30 | 37 | 52 | 21 (16–31) | 24 (20–29) | 19 (18–19) | 16 (15–16) | 56 |
| Sex | ||||||||
| Male | 1 (100) | 1 (100) | 1 (100) | 2 (50) | 3 (100) | 2 (100) | 2 (100) | 1 (100) |
| Female | 0 | 0 | 0 | 2 (50) | 0 | 0 | 0 | 0 |
| Proximate vaccine dose | ||||||||
| Second mRNA-1273 dose | 0 | 0 | 1 (100) | 0 | 0 | 1 (50) | 0 | 0 |
| Second BNT162b2-mRNA dose | 1 (100) | 1 (100) | 0 | 2 (50) | 3 (100) | 1 (50) | 1 (50) | 1 (100) |
| First mRNA-1273 dose | 0 | 0 | 0 | 1 (25) | 0 | 0 | 0 | 0 |
| First BNT162b2-mRNA dose | 0 | 0 | 0 | 1 (25) | 0 | 0 | 1 (50) | 0 |
| Single Ad.26.COV2.S dose | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Time to symptom onset, mean (range), h | 72 | 72 | 72 | 210 (48–600) | 48 | 60 (24–96) | 60 (24–72) | 72 |
| Troponin level | ||||||||
| Elevated | 1 (100) | 1 (100) | 1 (100) | 4 (100) | 3 (100) | 2 (100) | 2 (100) | 1 (100) |
| Not elevated | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Electrocardiogram findingsb | ||||||||
| Abnormal | 1 (100) | 1 (100) | 0 | NR | 3 (100) | 2 (100) | 2 (100) | 1 (100) |
| Normal | 0 | 0 | 1 (100) | NR | 0 | 0 | 0 | 0 |
| Echocardiogram findingsc | ||||||||
| LVEF <50% | 0 | 0 | 0 | 0 | NR | 1 (50) | 0 | 0 |
| LVEF ≥50% | 1 (100) | 1 (100) | 1 (100) | 4 (100) | NR | 1 (50) | 2 (100) | 1 (100) |
| Coronary artery imagingd | ||||||||
| Abnormal | 0 | 0 | 0 | NR | NR | 0 | NR | 0 |
| Normal | 1 (100) | 1 (100) | 1 (100) | NR | NR | 2 (100) | NR | 1 (100) |
| Not performed | 0 | 0 | 0 | NR | NR | 0 | NR | 0 |
| Cardiac MRIe | ||||||||
| Abnormal | 1 (100) | 1 (100) | 1 (100) | 4 (100) | 1 (100) | 2 (100) | 1 (50) | 1 (100) |
| Normal | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Not performed | 0 | 0 | 0 | 0 | 0 | 1 (50) | 0 | |
| SARS-CoV-2 PCR findings at presentation | ||||||||
| Positive | 0 | 0 | 0 | 0 | NR | 0 | 0 | 0 |
| Negative | 1 (100) | 1 (100) | 1 (100) | 4 (100) | NR | 2 (100) | 2 (100) | 1 (100) |
| Not performed | 0 | 0 | 0 | 0 | NR | 0 | 0 | 0 |
| Other viral testing at presentationf | ||||||||
| Positive | 0 | 0 | 0 | NR | NR | 0 | 0 | 0 |
| Negative | 1 (100) | 1 (100) | 1 (100) | NR | NR | 2 (100) | 2 (100) | 1 (100) |
| Not performed | 0 | 0 | 0 | NR | NR | 0 | 0 | 0 |
| History of prior SARS-CoV-2 infection | ||||||||
| Positive | 0 | 0 | 0 | 2 (50) | NR | NR | 0 | 1 (100) |
| Negative | 1 (100) | 0 | 1 (100) | 2 (50) | NR | NR | 2 (100) | 0 |
| Unknown | 0 | 1 (100) | 0 | 0 | NR | NR | 0 | 0 |
| Publication |
Garcia et al. [36] |
Deb et al. [37] |
Singh et al. [38] |
Minocha et al. [39] |
Cereda et al. [40] |
Albert et al. [41] |
Watkins et al. [42] |
|---|---|---|---|---|---|---|---|
| Characteristic | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) | No. (%) |
| Age, median (range), y | 39 | 67 | 24 | 17 | 21 | 24 | 20 |
| Sex | |||||||
| Male | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) |
| Female | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Proximate vaccine dose | |||||||
| Second mRNA-1273 dose | 0 | 1 (100) | 0 | 0 | 0 | 1 (100) | 0 |
| Second BNT162b2-mRNA dose | 1 (100) | 0 | 1 (100) | 1 (100) | 1 (100) | 0 | 1 (100) |
| First mRNA-1273 dose | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| First BNT162b2-mRNA dose | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Single Ad.26.COV2.S dose | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Time to symptom onset, mean (range), h | 6 | 6 | 72 | 48 | 30 | 96 | 48 |
| Troponin level | |||||||
| Elevated | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) |
| Not elevated | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Electrocardiogram findingsb | |||||||
| Abnormal | 1 (100) | 1 (100) | 0 | 1 (100) | 1 (100) | 0 | 1 (100) |
| Normal | 0 | 0 | 1 (100) | 0 | 0 | 1 (100) | 0 |
| Echocardiogram findingsc | |||||||
| LVEF <50% | 0 | 1 (100) | 0 | 0 | 0 | 0 | 0 |
| LVEF ≥50% | 1 (100) | 0 | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) |
| Coronary artery imagingd | |||||||
| Abnormal | 0 | NR | NR | NR | 0 | 0 | 0 |
| Normal | 1 (100) | NR | NR | NR | 1 (100) | 1 (100) | 1 (100) |
| Not performed | 0 | NR | NR | NR | 0 | 0 | 0 |
| Cardiac MRIe | |||||||
| Abnormal | 1 (100) | NR | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) |
| Normal | 0 | NR | 0 | 0 | 0 | 0 | 0 |
| Not performed | 0 | NR | 0 | 0 | 0 | 0 | 0 |
| SARS-CoV-2 PCR findings at presentation | |||||||
| Positive | 0 | 0 | 0 | 0 | 0 | 0 | |
| Negative | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) |
| Not performed | 0 | 0 | 0 | 0 | 0 | 0 | |
| Other viral testing at presentationf | |||||||
| Positive | 0 | 0 | 0 | 0 | 0 | 0 | NR |
| Negative | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) | 1 (100) | NR |
| Not performed | 0 | 0 | 0 | 0 | 0 | 0 | NR |
| History of prior SARS-CoV-2 infection | |||||||
| Positive | 0 | NR | 0 | 0 | NR | NR | NR |
| Negative | 1 (100) | NR | 0 | 1 (100) | NR | NR | NR |
| Unknown | 0 | NR | 1 (100) | 0 | NR | NR | NR |
Abbreviations: LVEF, left ventricular ejection fraction; MRI, magnetic resonance imaging; mRNA, messenger RNA; PCR, polymerase chain reaction; NR not reported.
a
Adapted from Montgomery et al. [12].
b
Electrocardiogram findings included ST elevations, T-wave inversions, and nonspecific ST changes.
c
Echocardiogram findings reported as LVEF.
d
Coronary artery imaging included CT coronary angiography and coronary angiography.
e
All abnormal cardiac MRIs reportedly meeting criteria for myocarditis.
f
Testing varied in each case for other acute viral infections; panels included some or all of these pathogens: coxsackie viruses, cytomegalovirus, Epstein-Barr virus, hepatitis A virus, hepatitis B virus, hepatitis C virus, herpes simplex virus, human herpesvirus 6, HIV, influenza viruses, and parvoviruses.