//Post covid myocarditis

Post covid myocarditis

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 (0.0046%)

Eleven patients were diagnosed with pericarditis (0.0056%).

Non- COVID infection cohort

27 patients had myocarditis (0.0046%)

52 had pericarditis (0.0088%)

Age adjusted hazard ratio


95% confidence interval, 0.93 to 1.00

Male sex, aHR 4.42; were associated with myocarditis

Male sex aHR 1.93; were associated with pericarditis

Post COVID-19 infection was not associated with either myocarditis or pericarditis

aHR 1.08; for myocarditis

aHR 0.53; 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)

0.31% 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 ……