"Abstract: ... This review explores the incidence, risk factors, clinical presentation, pathogenesis, management strategies, and outcomes associated with VRM [vaccine-related myocarditis]. The incidence of VRM is notably higher in male adolescents and young adults, especially after the second dose of mRNA vaccines. The pathogenesis appears to involve an immune-mediated process, but the precise mechanism remains mostly unknown so far. Most studies have suggested that VRM is mild and self-limiting, and responds well to conventional treatment. However, a recent nationwide study in Korea warns that severe cases, including fulminant myocarditis or death, are not uncommon in patients with COVID-19 VRM. The long-term cardiovascular consequences of VRM have not been well understood and warrant further investigation ...
EPIDEMIOLOGIC STUDIES FOR CORONAVIRUS DISEASE 2019 VACCINE-RELATED MYOCARDITIS ... The Korean government requires the reporting of all adverse events related to the COVID-19 vaccination, mandatory. The committee reviewed all reported cases and confirmed myocarditis or pericarditis after the vaccination, based on diagnostic appropriateness. According to the study, 44,276,704 individuals aged 12 and older received at least one dose of COVID-19 vaccine. Of these, 480 patients were confirmed to have VRM by an expert committee, resulting in an overall incidence rate of 1.08 per 100,000 vaccinated persons in Korea. This incidence was particularly high in males after receiving the second dose of mRNA vaccines, consistent with other studies. However, unlike other studies, this research provided more precise clinical outcomes for patients with VRM. Out of 480 VRM patients, 95 cases (19.8%) were identified as severe, including 85 intensive care unit admissions (17.7%), 36 cases of fulminant myocarditis (7.5%), 21 patients (4.4%) treated with extracorporeal membrane oxygenator (ECMO), 21 deaths (4.4%), and 1 heart transplantation (0.2%). In addition, 8 cases of sudden cardiac death (SCD) were reported following COVID-19 vaccination. SCD occurred in individuals under 45 years of age and within one week of the vaccination."
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