Atrial fibrillation as a precursor of mRNA-1273 SARS-CoV-2 vaccine-induced pericarditis

Summary: The mRNA vaccines against COVID-19 have been effective in reducing symptomatic cases globally, but cases of vaccine-related myocarditis/pericarditis have been reported, especially in male adolescents and young adults with symptom onset typically within 1 week after vaccination. A clinical framework is highlighted to guide providers on assessing, investigating, diagnosing, and reporting suspected and confirmed cases, with recommended standardized workup and imaging modalities such as echocardiography for unexplained elevations in troponin. Treatment is supportive, and diagnosis based on defined clinical criteria should be reported to public health authorities. Recommendations include vaccination in accordance with Health Canada and National Advisory Committee on Immunization guidelines, with deferral of a second dose for patients with suspected myocarditis/pericarditis after the first dose of an mRNA vaccine.

Summary: This study compares the incidence of myocarditis and pericarditis in emergency department or inpatient hospital encounters before and during the period of COVID-19 vaccination availability in a large US health care system.