Amr Nabaah
Advocate Lutheran General Childrens Hospital
Park Ridge, Illinois
Disclosure information not submitted.
Nadia Khan, MD
Pediatric Intensivist
Advocate Children's Hospital, United States
Disclosure information not submitted.
Fasiha Saeed, MD, FAAP
Pediatric Intensivist
Advocate Children's Hospital
Park Ridge, Illinois
Disclosure information not submitted.
Rohit Loomba, MD
Pediatric Cardiac Intensivist
Advocate Children's Hospital, United States
Disclosure information not submitted.
Waseem Cossor, MD
Pediatric Cardiologist
Advocate Children's Hospital, United States
Disclosure information not submitted.
Varsha Gharpure, MD, FAAP, FCCM
Pediatric Intensivist
Advocate Children's Hospital, United States
Disclosure information not submitted.
Title: Myocarditis Post-SARS-CoV-2 Vaccine Era: A Retrospective Case Series
Introduction: Centers for Disease Control has received reports of myocarditis temporally associated with SARS CoV-2 vaccination in teenagers. The objectives of this institutional review board approved study were to describe clinical characteristics and outcomes of children admitted with acute myocarditis post vaccine era.
Methods: Children aged 12-18 years hospitalized at Advocate Children’s Hospital, Illinois, with acute myocarditis between 1/1/21 to 6/29/21 were identified from the electronic medical record using ICD-10 codes for acute myocarditis. Primary outcome measures were in-hospital mortality, and length of stay in the hospital and ICU. Secondary outcomes included the need for organ support and complications. Data is expressed as median (IQR) or numbers and percentages.
Results: Of the 14 identified patients [Age: 15.8 years (14.87-17.4)], 9 received at least one dose of SARS-CoV-2 vaccine prior to admission [3 days (2.5-5)]. All except one from the non-vaccinated cohort were male, and 64% were white Caucasians and non-Hispanics (79%). All presented with chest pain and had elevated troponin levels [Peak: 15.03 ng/mL (3.68-30.01)]. Electrocardiogram revealed ST-T wave changes in 8 patients (57%). Echocardiogram revealed normal left ventricular function in all. MRI (n=11) revealed cardiac tissue edema abnormality in 9 and irreversible myocardial injury in 10 patients. There was no in-hospital mortality and median hospital length of stay (LOS) was 2.5 days (1.2-3.2). Ten required ICU care [2.1 days (0.9-2.5)]. Vasopressors/inotropes were needed in one unvaccinated patient. Among vaccinated patients: one with human entero/rhinovirus co-infection needed nasal cannula oxygen, one with prior history of SARS-CoV-2 infection received intravenous immunoglobulin and steroids, and two were discharged on beta-blockers for non-sustained ventricular tachycardia during hospitalization.
Conclusions: Adolescents presenting with acute myocarditis during this period were more likely to have recently received the SARS-CoV-2 vaccine. Our cohort had favorable outcomes and short hospital LOS. Further studies are needed to better understand if mRNA SARS CoV-2 vaccination is associated with an increased risk of developing myocarditis compared to baseline and if the course differs from those with non-vaccine related myocarditis.