Table 2.
Level of care, testing, and treatment by recovery status among patients with myocarditis after mRNA COVID-19 vaccination
| Patients fully or probably fully recovered (n=320) | Patients not recovered (n=65) | Patient recovery unknown (n=8) | p value | ||
|---|---|---|---|---|---|
| Highest level of care | |||||
| Hospitalised with no intensive care | 210 (66%) | 40 (62%) | 4 (50%) | 0·66 | |
| Hospitalised with intensive care | 85 (27%) | 12 (18%) | 2 (25%) | 0·22 | |
| Not hospitalised, managed as outpatient | 14 (4%) | 9 (14%) | 2 (25%) | 0·0074 | |
| Intensive care with ECMO | 0 | 1 (2%) | 0 | .. | |
| Unknown* | 11 (3%) | 3 (5%) | 0 | .. | |
| Patient restrictions on physical activity | |||||
| At time of initial myocarditis hospitalisation or diagnosis | 267 (83%) | 53 (82%) | 6 (75%) | 0·84 | |
| At time of last health-care provider follow-up | 91 (28%) | 31 (48%) | 3 (38%) | 0·0038 | |
| Cleared for physical activity and date of clearance known | 160/267 (60%) | 16/53 (30%) | 2/6 (33%) | 0·026 | |
| Median days from myocarditis onset to physical activity clearance (IQR) | 104 (63–135) | 114 (73–156) | 80 | 0·12 | |
| Patient cardiac MRI | |||||
| At time of initial myocarditis hospitalisation or diagnosis | 137 (43%) | 32 (49%) | 0 | 0·56 | |
| At time of healthcare provider follow-up | 114 (36%) | 36 (55%) | 1 (13%) | 0·0023 | |
| Patient echocardiogram | |||||
| At time of initial myocarditis hospitalisation or diagnosis | 257 (80%) | 55 (85%) | 7 (88%) | 0·53 | |
| At time of health care provider follow-up | 230 (72%) | 51 (78%) | 3 (38%) | 0·35 | |
| Patient troponin | |||||
| At time of initial myocarditis hospitalisation or diagnosis | 318 (99%) | 65 (100%) | 7 (88%) | 0·76 | |
| At time of healthcare provider follow-up | 166 (52%) | 33 (51%) | 1 (13%) | 0·86 | |
| Patient electrocardiogram | |||||
| At time of initial myocarditis hospitalisation or diagnosis | 210 (66%) | 34 (52%) | 6 (75%) | 0·059 | |
| At time of health-care provider follow-up | 251 (78%) | 55 (85%) | 5 (63%) | 0·34 | |
| Patient exercise stress test | |||||
| At time of health-care provider follow-up | 91 (28%) | 16 (25%) | 2 (25%) | 0·63 | |
| Patient ambulatory rhythm monitoring | |||||
| At time of health-care provider follow-up | 86 (27%) | 18 (28%) | 1 (13%) | 0·89 | |
| Prescribed medication at last provider follow-up | 68 (21%) | 33 (51%) | 3 (38%) | <0·0001 | |
| Daily medication types prescribed† | |||||
| Colchicine | 31 (10%) | 17 (26%) | 0 | 0·0005 | |
| β-blocker | 29 (9%) | 12 (18%) | 1 (13%) | 0·043 | |
| Non-steroidal anti-inflammatory | 21 (7%) | 9 (14%) | 1 (13%) | 0·081 | |
| Aspirin | 9 (3%) | 5 (8%) | 1 (13%) | 0·069 | |
| Angiotensin-converting enzyme inhibitor | 8 (3%) | 6 (9%) | 0 | 0·018 | |
| Diuretic | 3 (1%) | 3 (5%) | 0 | 0·063 | |
| Corticosteroid | 1 (<1%) | 3 (5%) | 0 | 0·016 | |
| Angiotensin II receptor blocker | 2 (1%) | 7 (11%) | 0 | <0·0001 | |
| Other medication | 3 (1%) | 2 (3%) | 1 (13%) | 0·19 | |
Data are n (%) unless otherwise specified. Data are based on the completion of 393 health-care provider surveys. Health-care provider determination of patient myocarditis recovery was provided for 393 patients, of whom 320 were considered fully or probably fully recovered, 65 were not considered recovered, and the health-care provider was unsure of the recovery status in eight patients, as shown in figure 1. Follow-up cardiac testing was performed, although the result of the test was not available for troponin concentration in three patients, echocardiogram in five patients, cardiac MRI in seven patients, exercise stress testing in five patients, and ambulatory rhythm monitoring in nine patients.
Some data were unknown because not all health-care providers who were surveyed knew the level of care the patient received as not all cared for the patient while they were in the hospital.
The denominator is based on patients who, as of their last health-care provider encounter, were recommended to use daily medication. ECMO=extracorporeal membrane oxygenation.