Impact of COVID-19 vaccination in post-COVID cardiac complications

• Published in: Vaccine 2023-02, Vol.41 (8), p.1524-1528
• Main Authors: Parodi, Josefina B., Indavere, Agustín, Bobadilla Jacob, Pamela, Toledo, Guillermo C., Micali, Rubén G., Waisman, Gabriel, Masson, Walter, Epstein, Eduardo D., Huerin, Melina S.
• Format: Article
• Language: English
• Subjects: Cardiac arrhythmia; Cardiomyopathy; Cardiovascular disease; Cardiovascular diseases; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - prevention & control; COVID-19 vaccines; COVID-19 Vaccines - adverse effects; Echocardiography; Evaluation; Heart diseases; Heart Diseases - epidemiology; Heart Diseases - etiology; Heart failure; Humans; Immunization; Infections; Long COVID; Mortality; Multivariate analysis; Myocarditis; Post-Acute COVID-19 Syndrome; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Signs and symptoms; Statistical analysis; Vaccination; Vaccination - adverse effects; Variables; Viral diseases; Viral infections
• ISSN: 0264-410X; 1873-2518
• DOI: 10.1016/j.vaccine.2023.01.052

•1883 vaccinated and unvaccinated post-COVID patients evaluated by echocardiogram.•2.92% presented pathological TTE findings consistent with post-COVID cardiac injury.•Unvaccinated patients presented more cardiac injury than vaccinated (4.1% vs 1.3%)•15% of the patients reported persistent symptoms at the post-COVID control.•Complete vaccination was associated with 48% reduction in risk of long-COVID symptoms. After the acute infection, COVID-19 can produce cardiac complications as well as long-COVID persistent symptoms. Although vaccination against COVID-19 represented a clear reduction in both mortality and ICU admissions, there is very little information on whether this was accompanied by a decrease in the prevalence of post-COVID cardiac complications. The aim of this study was to analyze the relationship between COVID-19 vaccination and the prevalence of post-COVID cardiac injury assessed by echocardiogram, and long-COVID persistent cardiac symptoms. Methods: All patients who consulted for post-COVID evaluation 14 days after discharge from acute illness were included. Patients with heart disease were excluded. The relationship between complete vaccination scheme (at least two doses applied with 14 days or more since the last dose) and pathological echocardiographic findings, as well as the relationship of vaccination with persistent long-COVID symptoms, were evaluated by multivariate analysis, adjusting for age, sex and clinical variables that would have shown significant differences in univariate analysis. Results: From 1883 patients, 1070 patients (56.8%) suffered acute COVID-19 without a complete vaccination scheme. Vaccination was associated with lower prevalence of cardiac injury (1.35% versus 4.11%, adjusted OR 0.33; 95% CI 0.17–0.65, p=0.01). In addition, vaccinated group had a lower prevalence of persistent long-COVID symptoms compared to unvaccinated patients (10.7% versus 18.3%, adjusted OR 0.52; 95% CI 0.40–0.69, p