Cardiac complications after SARS-CoV-2 infection and mRNA COVID-19 vaccination - PCORnet, United States, January 2021-January 2022
Block, JP; Boehmer, TK; Forrest, CB; et al., Morbidity and Mortality Weekly Report (MMWR)
Published
April 2022
Journal
Morbidity and Mortality Weekly Report (MMWR)
Abstract
Cardiac complications, particularly myocarditis and pericarditis, have been associated with SARS-CoV-2 (the virus that causes COVID-19) infection and mRNA COVID-19 vaccination. Multisystem inflammatory syndrome (MIS) is a rare but serious complication of SARS-CoV-2 infection with frequent cardiac involvement. Using electronic health record (EHR) data from 40 U.S. health care systems during January 1, 2021-January 31, 2022, investigators calculated incidences of cardiac outcomes (myocarditis; myocarditis or pericarditis; and myocarditis, pericarditis, or MIS) among persons aged ≥5 years who had SARS-CoV-2 infection, stratified by sex (male or female) and age group (5-11, 12-17, 18-29, and ≥30 years). Incidences of myocarditis and myocarditis or pericarditis were calculated after first, second, unspecified, or any (first, second, or unspecified) dose of mRNA COVID-19 (BNT162b2 [Pfizer-BioNTech] or mRNA-1273 [Moderna]) vaccines, stratified by sex and age group. Risk ratios (RR) were calculated to compare risk for cardiac outcomes after SARS-CoV-2 infection to that after mRNA COVID-19 vaccination. The incidence of cardiac outcomes after mRNA COVID-19 vaccination was highest for males aged 12-17 years after the second vaccine dose; however, within this demographic group, the risk for cardiac outcomes was 1.8-5.6 times as high after SARS-CoV-2 infection than after the second vaccine dose. The risk for cardiac outcomes was likewise significantly higher after SARS-CoV-2 infection than after first, second, or unspecified dose of mRNA COVID-19 vaccination for all other groups by sex and age (RR 2.2-115.2). These findings support continued use of mRNA COVID-19 vaccines among all eligible persons aged ≥5 years.
Authors
Jason P Block, Tegan K Boehmer, Christopher B Forrest, Thomas W Carton, Grace M Lee, Umed A Ajani, Dimitri A Christakis, Lindsay G Cowell, Christine Draper, Nidhi Ghildayal, Aaron M Harris, Michael D Kappelman, Jean Y Ko, Kenneth H Mayer, Kshema Nagavedu, Matthew E Oster, Anuradha Paranjape, Jon Puro, Matthew D Ritchey, David K Shay, Deepika Thacker, Adi V Gundlapalli
Keywords
BNT162 Vaccine; COVID-19/epidemiology/prevention & control; COVID-19 Vaccines/adverse effects; Female; Humans; Male; Myocarditis/epidemiology; Pericarditis/epidemiology/etiology; RNA, Messenger; SARS-CoV-2; United States/epidemiology; Vaccination/adverse effects
Short Summary
Heart problems after having COVID and after getting an mRNA COVID vaccine
RECOVER researchers used data from over 15 million people’s electronic health records (EHR) to compare how many people have heart problems after having COVID or getting an mRNA COVID vaccine. They used EHR data from 40 health systems in PCORnet, the National Patient Centered Clinical Research Network.
Researchers found that the chance of having heart problems is higher after having COVID than after getting an mRNA COVID vaccine for men and women in all age groups. The overall chance of having heart problems after having COVID or getting an mRNA COVID vaccine was very low across all ages and genders. These results support the continued use of mRNA COVID vaccines for all people ages 5 and older, who meet the vaccine criteria.