AUTHOR=Shiyovich Arthur , Plakht Ygal , Witberg Guy , Rotstein Amichai , Aviv Yaron , Wiessman Maya , Kornowski Ran , Hamdan Ashraf 

TITLE=Myocarditis following COVID-19 vaccination in adolescents: Cardiac magnetic resonance imaging study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.978592

DOI=10.3389/fcvm.2022.978592

ISSN=2297-055X

ABSTRACT=Introduction: Vaccination-associated myocarditis was reported following COVID-19 vaccine initially among persons aged 16 or older and recently among adolescents aged 12-15. 
Objectives: to describe the clinical and cardiac magnetic resonance (CMR) characteristics of adolescents aged 12-15 with myocarditis following the administration of the BNT162b2 mRNA COVID-19 vaccine.
Methods: CMR of adolescents with a clinical diagnosis of myocarditis following the first COVID-19 vaccine were analyzed.
Results: Overall 182,605 adolescent were vaccinated, of which 9 were diagnosed with clinically adjudicated myocarditis while CMR was performed in 5/9 patients (56%). Median age was 15 years, 4/5 (80%) males. All the patients we previously healthy. The median follow-up time, for the 5-included patients, was 206 (IQR 192-229, range 179-233) days. During the follow-up, no re-admissions, deaths, or any other cardiac events have occurred. 
The median time between the diagnosis to the CMR was 104 days (range 27-149). The median LVEF was within normal range 65% (range 62–69). The local T1 value was increased in 3/4 patients. T2 values were normal in 2/2 patients. The median LGE was 2% (range 0–6%) with inferolateral wall being the most common location (3/5). The patterns of the LGE were: (i) mid-wall in 3-patients; (ii) epicardial in 1-patient. LGE in the pericardium was present in 2/5 patients with pericardial effusion present in 4/5 patients.
Conclusions: CMR findings and clinical course of adolescents with COVID-19 vaccination associated myocarditis, are a bit higher compared to those of older patients, being relatively mild and potentially implying favourable outcomes.