The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients-A Large Population-Based Study
The authors declare no conflict of interest.
Myocarditis and pericarditis are potential post-acute cardiac sequelae of COVID-19 infection,
arising from adaptive immune responses.
We aimed to study the incidence of post-acute COVID-19 myocarditis and pericarditis.
Retrospective cohort study
N = 196,992 adults after COVID-19 infection
Clalit Health Services members in Israel
March 2020 and January 2021
The control cohort (no infection)
N = 590,976 adults
Age- and sex-matched
COVID infection cohort
Nine post-COVID-19 patients developed myocarditis (%)
Eleven patients were diagnosed with pericarditis (%).
Non- COVID infection cohort
27 patients had myocarditis (%)
52 had pericarditis (%)
Age adjusted hazard ratio
95% confidence interval, to
Male sex, aHR ; were associated with myocarditis
Male sex aHR ; were associated with pericarditis
Post COVID-19 infection was not associated with either myocarditis or pericarditis
aHR ; for myocarditis
aHR ; for myocarditis
We did not observe an increased incidence of neither pericarditis nor myocarditis in adult patients recovering from COVID-19 infection.
Myocarditis and pericarditis (21st March 2022)
In 2017
About 2,000 hospital admissions for myocarditis
Two-thirds of cases were in men
Median age for men, 33
Mostly viral
Presentation of acute myocarditis
Subclinical disease too,
heart failure, chest pain, shortness of breath, palpitations and fatigue.
Dilated cardiomyopathy and chronic heart failure
Sudden death syndrome
Myocarditis implicated in 12% of sudden deaths under the age of 40
Acute pericarditis
Often similar presentation
Some concurrent myocardial involvement (myopericarditis)
Constrictive pericarditis is uncommon
Can myocarditis or pericarditis be caused by coronavirus (COVID-19) infection?
It is now recognised that COVID-19 infection can lead to myocarditis or pericarditis
Professional athletes are an atypical group
Published online 2021 May 27
1,597 athletes with recent SARS-CoV-2 infection
(March 1, 2020, through December 15, 2020)
% were diagnosed with myocarditis using a symptom-based screening
2.3% were diagnosed with clinical or subclinical myocarditis using cardiac magnetic resonance screening
Is there an association of myocarditis or pericarditis following COVID-19 vaccination?
Many studies have now shown that there is an increased risk of myocarditis following vaccination with an mRNA vaccine,
especially in young men under the age of 40.
Many of the studies have only limited follow up ……
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