{
  "abstract": "Background The long-term effects of myocarditis following COVID-19 vaccination on cardiac function and symptoms remain unclear.Purpose To assess the long-term effects of myocarditis following COVID-19 vaccination on cardiac function, inflammatory biomarkers and symptoms.Methods Patients with myocarditis within 50 days of receiving COVID-19 vaccination (2021–2022) were invited to follow-up approximately 2 years after initial hospitalisation. Follow-up assessment included echocardiography, biomarkers, ECG, lung ultrasound (LUS) and symptom questionnaires. Patients with myocarditis following COVID-19 vaccination (V-myocarditis) were compared with non-vaccine-related myocarditis (NV-myocarditis) controls admitted during the same period.Results 17 patients with V-myocarditis (median age 47 (27–59) years, 53% women) were included. Median time from vaccination to admission was 6 days, with 88% admitted within 30 days. At follow-up (28±6 months), patients with V-myocarditis showed mildly impaired left ventricular (LV) function (median global longitudinal strain (GLS) 16.0% (13.2%–18.2%)) and diastolic dysfunction in 71%. Right ventricular (RV) and LUS findings were preserved. Biomarkers normalised from admission to follow-up with significant reductions in troponin-I (p<0.001) and C-reactive protein (p=0.001), while 35% showed persistent low-grade inflammation. Symptoms were common at follow-up, including fatigue (35%) and chest pain (41%). Compared with NV-myocarditis, patients with V-myocarditis had similar symptoms and biomarker recovery, but lower GLS at follow-up (NV-myocarditis: 18.5% (15.4%–20.3%), p=0.04).Conclusion In one of the longest reported follow-up studies of myocarditis following COVID-19 vaccination, patients exhibited mild LV and diastolic dysfunction, preserved RV function and overall normalised biomarkers. A notable proportion continued reporting symptoms, highlighting the need for long-term follow-up.",
  "authors": [
    {
      "affiliations": [
        "Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark"
      ],
      "name": "Mohammad Nizar Ramadan"
    },
    {
      "affiliations": [
        "Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark"
      ],
      "name": "Filip Soeskov Davidovski"
    },
    {
      "affiliations": [
        "Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark"
      ],
      "name": "Caroline Espersen"
    },
    {
      "affiliations": [
        "Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark"
      ],
      "name": "Ali Hikmat Al-Rubai"
    },
    {
      "affiliations": [
        "Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark"
      ],
      "name": "Ayat Khoraizat"
    },
    {
      "affiliations": [
        "Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark"
      ],
      "name": "Niklas Dyrby Johansen"
    },
    {
      "affiliations": [
        "Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark"
      ],
      "name": "Kristoffer Grundtvig Skaarup"
    },
    {
      "affiliations": [
        "Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark"
      ],
      "name": "Mats Christian Højbjerg Lassen"
    },
    {
      "affiliations": [
        "Statens Serum Institut, Copenhagen, Denmark"
      ],
      "name": "Anders Hviid"
    },
    {
      "affiliations": [
        "Statens Serum Institut, Copenhagen, Denmark"
      ],
      "name": "Tyra Grove"
    },
    {
      "affiliations": [
        "Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Department of Cardiology, Department of Cardiology, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark"
      ],
      "name": "Manan Pareek"
    },
    {
      "affiliations": [
        "Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark",
        "Department of Cardiology, Herlev & Gentofte Hospital, Hellerup, Denmark",
        "Department of Cardiology, Department of Cardiology, Copenhagen University Hospital – Rigshospitalet, Copenhagen, Denmark",
        "Steno Diabetes Center, Copenhagen, Denmark"
      ],
      "name": "Tor Biering-Sørensen"
    }
  ],
  "title": "Long-term effects on cardiac function and symptoms in patients with myocarditis following COVID-19 vaccination: the ECHOVID-19 Long-term Study",
  "uid": "bcc082b2-2339-54ae-8eeb-ef890d9ce267"
}