IMR Press / RCM / Volume 23 / Issue 10 / DOI: 10.31083/j.rcm2310339
Open Access Review
CMR Manifestations, Influencing Factors and Molecular Mechanism of Myocarditis Induced by COVID-19 Mrna Vaccine
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1 Department of Radiology, The Second Affiliated Hospital of Kunming Medical University, 650500 Kunming, Yunnan, China
2 Department of Radiology, RenJi Hospital, School of Medicine, Shanghai Jiao Tong University, 200127 Shanghai, China
3 Department of Radiology, The Third Affiliated Hospital of Kunming Medical University, Yunnan Cancer Hospital, Xishan District, 650118 Kunming, Yunnan, China
*Correspondence: xujianrong0311@126.com (Jian-Rong Xu); wlmssmu@126.com (Lian-Ming Wu)
These authors contributed equally.
Academic Editor: Alpo Vuorio
Rev. Cardiovasc. Med. 2022, 23(10), 339; https://doi.org/10.31083/j.rcm2310339
Submitted: 28 July 2022 | Revised: 13 August 2022 | Accepted: 26 August 2022 | Published: 11 October 2022
(This article belongs to the Special Issue Cardiovascular Health and COVID-19)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Although immunization with the 2019 coronavirus disease (COVID-19) mRNA vaccine is considered to be an effective measure to reduce the number of serious cases or deaths associated with COVID-19, rare cases of cardiac complications have been reported in the literature, encompassing acute myocardial injury, arrhythmia, vasculitis, endothelial dysfunction, thrombotic myocardial infarction and myocarditis. Interestingly, patients diagnosed with myocarditis after receiving the COVID-19 mRNA vaccine exhibit abnormal cardiac magnetic resonance (CMR) findings, suggesting CMR can be a valuable non-invasive diagnostic tool. In populations immunized with the COVID-19 mRNA vaccine, the risk in teenagers and young men is significantly higher. Myocardial injury in male patients is mainly myocarditis, while in female patients, myocarditis and pericardial effusion are predominantly found. Generally, the symptoms of myocarditis are relatively mild and complete recovery can be achieved. Moreover, the incidence rate associated with the second dose is significantly higher than with the first or third dose. This article brings together the latest evidence on CMR characteristics, influencing factors and pathogenesis of myocarditis caused by the COVID-19 mRNA vaccine. At the same time, we make recommendations for populations requiring immunization with the COVID-19 mRNA vaccine.

Keywords
COVID-19
mRNA vaccines
myocarditis
CMR
pathogenesis
Funding
82171884/National Natural Science Foundation of China
Figures
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