Myocarditis Following COVID-19 Vaccination: Cardiac Imaging Findings in 118 Studies

Tomography. 2022 Jul 30;8(4):1959-1973. doi: 10.3390/tomography8040164.

Abstract

We reviewed the reported imaging findings of myocarditis in the literature following COVID-19 vaccination on cardiac imaging by a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), and Google Scholar. In total, 532 cases of myocarditis after COVID-19 vaccination were reported (462, 86.8% men and 70, 13.2% women, age range 12 to 80) with the following distribution: Pfizer-BioNTech: 367 (69%), Moderna: 137 (25.8%), AstraZeneca: 12 (2.3%), Janssen/Johnson & Johnson: 6 (1.1%), COVAXIN: 1 (0.1%), and unknown mRNA vaccine: 9 (1.7%). The distribution of patients receiving vaccine dosage was investigated. On cardiac MR Imaging, late intravenous gadolinium enhancement (LGE) was observed mainly in the epicardial/subepicardial segments (90.8%, 318 of 350 enhancing segments), with the dominance of inferolateral segment and inferior walls. Pericardial effusion was reported in 13.1% of cases. The vast majority of patients (94%, 500 of 532) were discharged from the hospital except for 4 (0.7%) cases. Post-COVID-19 myocarditis was most commonly reported in symptomatic men after the second or third dose, with CMRI findings including LGE in 90.8% of inferior and inferolateral epicardial/subepicardial segments. Most cases were self-limited.

Keywords: Janssen/Johnson & Johnson; Moderna; Pfizer-BioNTech; coronavirus; myocarditis.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 Vaccines* / adverse effects
  • COVID-19* / prevention & control
  • Child
  • Contrast Media
  • Female
  • Gadolinium
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Myocarditis* / diagnostic imaging
  • Myocarditis* / etiology
  • Vaccination
  • Vaccines, Synthetic
  • Young Adult
  • mRNA Vaccines

Substances

  • COVID-19 Vaccines
  • Contrast Media
  • Vaccines, Synthetic
  • mRNA Vaccines
  • Gadolinium

Grants and funding

This research received no external funding.