COVID-19 vaccination and carditis in children and adolescents: A systematic review and meta-analysis

Hou In Chou, Oscar, Mui, Jonathan, To Chung, Cheuk, Radford, Danny, Ranjithkumar, Simon, Evbayekha, Endurance, Nam, Ronald, Pay, Levent, Satti, Danish Iltaf, Garcia-Zamora, Sebastian, Bazoukis, George, Çinier, Göksel, Lee, Sharen, Vassiliou, Vassilios S. ORCID:, Liu, Tong, Tse, Gary and Wong, Ian Chi Kei and Cardiovascular Analytics Group, International Health Informatics Study Network (2022) COVID-19 vaccination and carditis in children and adolescents: A systematic review and meta-analysis. Clinical Research in Cardiology, 111 (10). 1161–1173. ISSN 1861-0684

[thumbnail of Supplementary Appendix]
PDF (Supplementary Appendix)
Available under License Creative Commons Attribution.

Download (62kB) | Preview
[thumbnail of Chou_etal_2022_ClinResCardio]
PDF (Chou_etal_2022_ClinResCardio) - Published Version
Available under License Creative Commons Attribution.

Download (1MB) | Preview


Background: Coronavirus Disease-2019 (COVID-19) vaccination has been associated with the development of carditis, especially in children and adolescent males. However, the rates of these events in the global setting have not been explored in a systematic manner. The aim of this systematic review and meta-analysis is to investigate the rates of carditis in children and adolescents receiving COVID-19 vaccines. Methods: PubMed, Embase and several Latin American databases were searched for studies. The number of events, and where available, at-risk populations were extracted. Rate ratios were calculated and expressed as a rate per million doses received. Subgroup analysis based on the dose administered was performed. Subjects ≤ 19 years old who developed pericarditis or myocarditis following COVID-19 vaccination were included. Results: A total of 369 entries were retrieved. After screening, 39 articles were included. Our meta-analysis found that 343 patients developed carditis after the administration of 12,602,625 COVID-19 vaccination doses (pooled rate per million: 37.76; 95% confidence interval [CI] 23.57, 59.19). The rate of carditis was higher amongst male patients (pooled rate ratio: 5.04; 95% CI 1.40, 18.19) and after the second vaccination dose (pooled rate ratio: 5.60; 95% CI 1.97, 15.89). In 301 cases of carditis (281 male; mean age: 15.90 (standard deviation [SD] 1.52) years old) reported amongst the case series/reports, 261 patients were reported to have received treatment. 97.34% of the patients presented with chest pain. The common findings include ST elevation and T wave abnormalities on electrocardiography. Oedema and late gadolinium enhancement in the myocardium were frequently observed in cardiac magnetic resonance imaging (CMR). The mean length of hospital stay was 3.91 days (SD 1.75). In 298 out of 299 patients (99.67%) the carditis resolved with or without treatment. Conclusions: Carditis is a rare complication after COVID-19 vaccination across the globe, but the vast majority of episodes are self-limiting with rapid resolution of symptoms within days.

Item Type: Article
Uncontrolled Keywords: carditis,covid-19,myocarditis,pericarditis,vaccine,cardiology and cardiovascular medicine,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2705
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health
Faculty of Science > Research Groups > Norwich Epidemiology Centre
Faculty of Medicine and Health Sciences > Research Groups > Norwich Epidemiology Centre
Related URLs:
Depositing User: LivePure Connector
Date Deposited: 19 Jul 2022 13:31
Last Modified: 19 May 2023 09:39
DOI: 10.1007/s00392-022-02070-7

Actions (login required)

View Item View Item