Is There a Causal Link Between Acute Myocarditis and COVID-19 Vaccination: An Umbrella Review of Published Systematic Reviews and Meta-Analyses.

IF 2.3 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Clinical Medicine Insights. Cardiology Pub Date : 2024-01-18 eCollection Date: 2024-01-01 DOI:10.1177/11795468231221406

Amine Bouchlarhem, Soumia Boulouiz, Zakaria Bazid, Nabila Ismaili, Noha El Ouafi

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Abstract

Introduction: A few months after the beginning of the coronavirus disease of 2019 (COVID-19) vaccination, several reports of myocarditis secondary to the vaccines were published, sometimes with fulminant cases, but until today there is no proven causal link between these 2 events, but with many hypotheses proposed.

Methods: A systematic review of current evidence regarding myocarditis after COVID-19 vaccination was performed by searching several databases including PubMed/Medline and Web of Science. The quality of Meta-analysis was assessed using the AMSTAR-2 tool as well as other qualitative criteria.

Results: Our umbrella review appraised 4 Meta-analysis of retrospective studies (range: 5-12), The number of vaccine doses included ranged from 12 to 179 million, with the number of myocarditis cases observed ranging from 343 to 1489. All types of vaccines were evaluated, with no exclusions. The overall incidence ranged from 0.89 to 2.36 cases of myocarditis per 100 000 doses of vaccine received. Heterogeny was assessed in 3 of the Meta-analysis, and was highly significant (>75%) in all included studies, and with a significant P-value (P < .05). Regarding publication bias, 3 of the Meta-analysis conducted the egger and begg regression, with a significant result in only 1. Regarding the assessment of the methodology by the AMSTAR-2 scale indicating that the quality was very critical in 1, low in 2, and moderate in 1 Meta-analysis.

Conclusion: The quality of current non-randomized evidence on real causality and incidence of myocarditis after COVID-19 vaccine is still low.

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急性心肌炎与接种 COVID-19 疫苗之间是否存在因果关系？对已发表的系统综述和元分析的总体回顾。

导言：在 2019 年冠状病毒病（COVID-19）疫苗接种开始几个月后，发表了几篇继发于疫苗的心肌炎的报道，有时会出现暴发性病例，但直到今天，这两起事件之间的因果关系仍未得到证实，但提出了许多假设：方法：通过搜索多个数据库（包括 PubMed/Medline 和 Web of Science），对有关接种 COVID-19 疫苗后心肌炎的现有证据进行了系统性综述。采用 AMSTAR-2 工具和其他定性标准对 Meta 分析的质量进行了评估：我们的综述评估了 4 项回顾性研究的 Meta 分析（范围：5-12），纳入的疫苗剂量从 1,200 万剂到 1.79 亿剂不等，观察到的心肌炎病例数从 343 例到 1489 例不等。所有类型的疫苗都进行了评估，无一例外。每 10 万剂疫苗接种中心肌炎的总发病率从 0.89 例到 2.36 例不等。有 3 项 Meta 分析对异质性进行了评估，在所有纳入的研究中，异质性都非常显著（>75%），且 P 值（P 结论）显著：目前有关接种 COVID-19 疫苗后心肌炎的真正因果关系和发病率的非随机证据的质量仍然很低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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