2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T677,The benefit-risk of coronavirus disease 2019 (COVID-19) vaccination in children remains unclear. We evaluated the effects of mRNA vaccines on COVID-19 hospitalization, pericarditis/myocarditis, and MISC-C in children 6-17 years old. The Madrid Health System Registry was linked with 3 databases of the Madrilenian Health Service (primary care, hospital admissions, and pharmacy) to identify eligible children 6-17 years of age. We matched children receiving an mRNA vaccine with 5 controls and compared 240-day risks for vaccines and controls, with bootstrapping to obtain 95% confidence intervals. Effectiveness was defined as 1 minus the risk ratio. All analyses were conducted by age group (6-11 and 12-17 years). In 183,273 vaccinated and 916,365 controls 6-11 years old, the estimated risk difference (95% CI) of COVID-19 hospitalization was -1.2 per 100,000 (-6.6 to 4.0) for vaccinated versus controls; effectiveness 9.0% (-36 to 49). The risk difference of multisystem inflammatory syndrome in children was -1.4 per 100,000 (-4.7 to 2.3); effectiveness 27.0% (-54 to 76). No cases of myocarditis or pericarditis occurred. In 277,561 vaccinated and 1,387,805 controls 12-17 years old, the estimated risk difference of COVID-19 hospitalization was -5.3 per 100,000 (-9.0 to -2.0); effectiveness 45% (18-72). The risk difference of multisystem inflammatory syndrome in children was -1.3 per 100,000 (-3.0 to 0.8), effectiveness 42% (-31 to 83). The risk ratio of pericarditis/myocarditis for vaccinated versus controls was 1.09 (0.60-1.70). The risks and benefits of COVID-19 vaccines were small in a general population of children 6-17 years of age.31:T8f0, Background: The benefit–risk of coronavirus disease 2019 (COVID-19) vaccination in children remains unclear. We evaluated the effects of mRNA vaccines on COVID-19 hospitalization, pericarditis/myocarditis, and MISC-C in children 6–17 years old. Methods: The Madrid Health System Registry was linked with 3 databases of the Madrilenian Health Service (primary care, hospital admissions, and pharmacy) to identify eligible children 6–17 years of age. We matched children receiving an mRNA vaccine with 5 controls and compared 240-day risks for vaccines and controls, with bootstrapping to obtain 95% confidence intervals. Effectiveness was defined as 1 minus the risk ratio. All analyses were conducted by age group (6–11 and 12–17 years). Results: In 183,273 vaccinated and 916,365 controls 6–11 years old, the estimated risk difference (95% CI) of COVID-19 hospitalization was −1.2 per 100,000 (−6.6 to 4.0) for vaccinated versus controls; effectiveness 9.0% (−36 to 49). The risk difference of multisystem inflammatory syndrome in children was −1.4 per 100,000 (−4.7 to 2.3); effectiveness 27.0% (−54 to 76). No cases of myocarditis or pericarditis occurred. In 277,561 vaccinated and 1,387,805 controls 12–17 years old, the estimated risk difference of COVID-19 hospitalization was −5.3 per 100,000 (−9.0 to −2.0); effectiveness 45% (18–72). The risk difference of multisystem inflammatory syndrome in children was −1.3 per 100,000 (−3.0 to 0.8), effectiveness 42% (−31 to 83). The risk ratio of pericarditis/myocarditis for vaccinated versus controls was 1.09 (0.60–1.70). Conclusions: The risks and benefits of COVID-19 vaccines were small in a general population of children 6–17 years of age. 32:Te59,The rarity of severe diseases following COVID-19 infection balanced against rare COVID-19 vaccination-related adverse effects is an important consideration for vaccination policies. We aimed to assess the short-term and long-term risks of vascular and inflammatory diseases following first COVID-19 diagnosis and vaccination in children and young people. In this retrospective, population-based cohort study, we analysed whole-population linked electronic health records for all individuals in England aged younger than 18 years, registered with a general practitioner, and with known age, sex, and region of residence, between Jan 1, 2020, and Dec 31, 2022. Outcomes were arterial thrombotic events, venous thrombotic events, thrombocytopenia, myocarditis or pericarditis, and inflammatory conditions. COVID-19 diagnosis was defined as the earliest record of a positive SARS-CoV-2 PCR or antigen test, or a COVID-19 diagnosis code in primary-care or secondary-care records; COVID-19 vaccination was defined as the earliest documented receipt of the BNT162b2 vaccine (the predominant vaccine during the study period). Adjusted hazard ratios (aHRs) for all outcomes were estimated by time since a first COVID-19 diagnosis during Jan 1, 2020-March 31, 2022 and by time since a first COVID-19 vaccination during Aug 6, 2021-Dec 31, 2022, adjusting for age, sex, ethnicity, region, deprivation, general practitioner contact frequency, and medication use. Of 13 896 125 individuals younger than 18 years (6 784 260 [48·8%] female and 7 111 865 [51·2%] male; 9 979 420 [71·7%] White), 3 903 410 (28·1%) had a COVID-19 diagnosis. COVID-19 diagnosis (compared with no or before diagnosis) was associated with higher risk of arterial thromboembolism (aHR 2·33 [95% CI 1·20-4·51]), venous thromboembolism (4·90 [3·66-6·55]), thrombocytopenia (3·64 [2·21-6·00]), myocarditis or pericarditis (3·46 [2·06-5·80]), and inflammatory conditions (14·84 [11·01-19·99]) in the first week after diagnosis. Incidence declined in weeks 2-4, but remained elevated to beyond 12 months for venous thromboembolism (1·39 [1·14 -1·69]), thrombocytopenia (1·42 [1·01-2·00]), and myocarditis or pericarditis (1·42 [1·05-1·91]). Among 9 245 395 individuals aged between 5 and younger than 18 years who were eligible for vaccination (4 510 490 [48·8%] female and 4 734 905 [51·2%] male; 6 684 140 [72·3%] White), 3 407 560 (36·9%) received a first vaccine. COVID-19 vaccination (compared with no or before vaccination) was associated with elevated risk of myocarditis or pericarditis within the first 4 weeks after vaccination (1·84 [1·25-2·72]). The 6-month absolute excess risks for myocarditis or pericarditis were 2·24 (1·11-3·80) per 100 000 individuals after diagnosis versus before diagnosis or undiagnosed, and 0·85 (0·07-1·91) after vaccination versus before vaccination or unvaccinated. Children and young people have higher risks of rare vascular and inflammatory diseases up to 12 months after a first COVID-19 diagnosis and higher risk of rare myocarditis or pericarditis up to 4 weeks after a first BNT162b2 vaccine, although the risk following vaccination is substantially lower than the risk following infection. These findings are of great importance for national policy makers and caregivers considering vaccination consent for children, and support the public health strategy of COVID-19 vaccination in children and young people to mitigate the more frequent and persistent risks associated with SARS-CoV-2 infection. Wellcome Trust, British Heart Foundation Data Science Centre, and Health Data Research UK.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Myocarditis: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Myocarditis (condition). Clinician-written summaries and actionable practice insights. 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no randomized or observational study design applies.","value_numeric":null},{"paper_doi":"10.1161/cir.0000000000001476","tag_type":"warning","value":"This is an expert consensus statement (Level of Evidence 7); most recommendations are based on extrapolation from competitive athlete or general cardiology data due to limited tactical athlete-specific evidence.","value_numeric":null}],"summaries":{"what_studied":"This ACC/AHA scientific statement provides clinical guidance for managing cardiovascular disease and cardiovascular risk in tactical athletes (firefighters, law enforcement officers, military personnel), covering 11 topic areas from preparticipation evaluation to arrhythmias, cardiomyopathies, congenital heart disease, and environmental exposures.","key_result":"The statement delivers structured 'Clinical Considerations Tables' across 11 sections, framing fitness-for-duty decisions around the unique occupational demands of tactical athletes — including the downstream risk to teammates, community safety, and mission success when a cardiovascular event occurs on duty.","limitations":"This is a consensus expert statement, not a systematic review or meta-analysis; tactical athlete-specific evidence is limited in many areas, with recommendations often extrapolated from competitive athlete or general population data.","practice_takeaway":"Clinicians evaluating tactical athletes with cardiovascular conditions should use the structured Clinical Considerations Tables in this statement, which account for occupational task demands unique to this population — not just standard sports cardiology or general cardiology thresholds. Fitness-for-duty decisions should include explicit discussion of risk to the individual, teammates, and mission."}},{"doi":"10.1016/j.jacc.2026.07.003","pmid":"42693699","title":"Clinical Considerations for the Care of the Tactical Athlete With Cardiovascular Abnormalities","journal_title":"JACC","journal_issn":"0735-1097","published_at":"2026-09-03T00:00:00.000Z","url":"https://doi.org/10.1016/j.jacc.2026.07.003","source_score":39,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-09T06:21:06.768Z","updated_at":"2026-09-09T06:21:06.768Z","tags":[{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"condition","value":"Aortopathy","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"condition","value":"Bicuspid Aortic Valve","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"condition","value":"Cardiac Channelopathy","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"condition","value":"Cardiovascular Disease","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"condition","value":"Congenital Heart Disease","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"condition","value":"Genetic Cardiomyopathy","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"condition","value":"Myocarditis","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"condition","value":"Spontaneous Coronary Artery Dissection","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"condition","value":"Sudden Cardiac Arrest","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"condition","value":"Syncope","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"study_design","value":"Scientific Statement / Expert Consensus","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"warning","value":"No sample size is applicable — this is a consensus scientific statement, not an original research study.","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"warning","value":"The document was published in 2026; some referenced clinical considerations tables may rely on earlier evidence bases from competitive athlete guidelines.","value_numeric":null},{"paper_doi":"10.1016/j.jacc.2026.07.003","tag_type":"warning","value":"The study design is best classified as expert consensus/scientific statement; no randomization or comparator group is present.","value_numeric":null}],"summaries":{"what_studied":"This ACC/AHA scientific statement provides clinical guidance for managing cardiovascular disease and cardiovascular risk in tactical athletes (firefighters, law enforcement officers, military personnel), covering 11 topic areas from preparticipation evaluation to environmental exposures and arrhythmias.","key_result":"The statement delivers 11 sections of expert consensus-based Clinical Considerations Tables addressing cardiovascular conditions in tactical athletes, with emphasis on how cardiovascular events in this population can affect not only the individual but also teammates, community safety, and mission success.","limitations":"As a scientific statement (not a systematic review or RCT), recommendations are largely expert consensus-driven with limited tactical athlete-specific clinical trial data; the document acknowledges reliance on general sports cardiology evidence where tactical athlete-focused data are unavailable.","practice_takeaway":"Clinicians caring for tactical athletes (firefighters, police, military) should apply the condition-specific Clinical Considerations Tables in this statement when assessing fitness for full duty, particularly given the unique occupational stakes of a cardiovascular event in these roles. Evaluation frameworks should account for both the athlete's safety and downstream risks to teammates and the public."}},{"doi":"10.1093/europace/euag153","pmid":"42669046","title":"Workup and management of rhythm disorders in myocarditis and inflammatory cardiomyopathy: a clinical consensus statement of the European Heart Rhythm Association and the Heart Failure Association of the ESC, the ESC Working Group on Myocardial & Pericardial Diseases, the European Association of Preventive Cardiology of the ESC, the Heart Rhythm Society, the Asian Pacific Heart Rhythm Society, and the Latin American Heart Rhythm Society","journal_title":"Europace","journal_issn":"1099-5129","published_at":"2026-08-28T00:00:00.000Z","url":"https://doi.org/10.1093/europace/euag153","source_score":40,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-31T06:18:42.682Z","updated_at":"2026-08-31T06:18:42.682Z","tags":[{"paper_doi":"10.1093/europace/euag153","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"condition","value":"Atrial Arrhythmia","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"condition","value":"Atrioventricular Conduction Disease","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"condition","value":"Inflammatory Cardiomyopathy","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"condition","value":"Myocarditis","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"condition","value":"Sinus Node Dysfunction","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"condition","value":"Ventricular Arrhythmia","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"modality","value":"Antiarrhythmic Therapy","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"modality","value":"Catheter Ablation","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"modality","value":"Immunosuppression","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"modality","value":"Implantable Cardiac Device","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"study_design","value":"Clinical Consensus Statement","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"warning","value":"Age group tagged as 'adult' based on typical myocarditis/Infl-CMP literature, but the document does not explicitly restrict its scope to adults.","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"warning","value":"No patient-level data or sample size is reported — this is an expert consensus document, not a primary research study; level of evidence is largely opinion- or observational-based.","value_numeric":null},{"paper_doi":"10.1093/europace/euag153","tag_type":"warning","value":"The 'hot-to-cold' phase framework is a conceptual construct introduced by this consensus; its clinical boundaries are not yet validated by prospective trials.","value_numeric":null}],"summaries":{"what_studied":"This multinational clinical consensus statement evaluates the workup and management of rhythm disorders (atrioventricular conduction disease, ventricular arrhythmias, atrial arrhythmias, and sinus node dysfunction) in myocarditis and inflammatory cardiomyopathy (Infl-CMP), using a phase-aware framework (hot, hot-to-cold, and cold phases) integrated with genetic background and disease stage.","key_result":"The statement establishes a structured, phase-stratified framework for arrhythmia management: during active inflammation (hot phase), antiarrhythmic therapy is paired with aetiology-targeted treatment or immunosuppression; in later stages (cold phase), substrate-based strategies — pharmacological therapy, device implantation, or catheter ablation — are prioritized, with particular emphasis on the hot-to-cold transition as a high-risk arrhythmogenic window.","limitations":"Consensus advice is graded as opinion-, observational-, or randomized trial-based, reflecting a limited randomized evidence base in this field; formal recommendations are therefore driven largely by expert consensus and observational data.","practice_takeaway":"Clinicians should recognize myocarditis as an underappreciated cause of serious arrhythmias and use disease phase (hot vs. cold) and genetic background to guide timing of antiarrhythmic therapy, immunosuppression, device implantation, and ablation. The hot-to-cold transition period warrants heightened arrhythmic surveillance and risk stratification before committing to permanent device or ablation strategies."}},{"doi":"10.1007/s00246-026-04424-8","pmid":"42635737","title":"Cardiovascular Sequelae After SARS-CoV-2 in Children: From Myocardial Injury to Dysautonomia and Implications for Phenotype-Guided Follow-Up","journal_title":"Pediatric Cardiology","journal_issn":"0172-0643","published_at":"2026-08-24T00:00:00.000Z","url":"https://doi.org/10.1007/s00246-026-04424-8","source_score":18,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-28T06:25:15.113Z","updated_at":"2026-08-28T06:25:15.113Z","tags":[{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"category","value":"Pediatrics","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"condition","value":"Autonomic Dysfunction","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"condition","value":"Multisystem Inflammatory Syndrome in Children","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"condition","value":"Myocarditis","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"condition","value":"Post-Acute Sequelae of COVID-19","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"condition","value":"Postural Orthostatic Tachycardia Syndrome","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"warning","value":"Multiple MUSIC study publications (echocardiography, strain, CMR) share overlapping patient populations and were not treated as independent cohorts in this review.","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"warning","value":"Several prevalence figures for residual GLS and CMR abnormalities come from small, selected cohorts enriched for severe disease or specialist referral, likely overestimating true rates.","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"warning","value":"The autonomic dysfunction cohorts (e.g., POTS prevalence of 62.5%) were drawn from specialist rehabilitation or syncope clinics, not general post-COVID populations.","value_numeric":null},{"paper_doi":"10.1007/s00246-026-04424-8","tag_type":"warning","value":"This is a narrative (not systematic) review; quantitative pooling was not performed due to study heterogeneity, so prevalence figures cited are from individual cohorts and should not be interpreted as population estimates.","value_numeric":null}],"summaries":{"what_studied":"Narrative review of paediatric cardiovascular sequelae after SARS-CoV-2, covering MIS-C, subclinical myocardial dysfunction (GLS, CMR), and autonomic dysfunction in children; literature search January 2020 – May 2026, minimum 4-week follow-up required for inclusion.","key_result":"Overt cardiac dysfunction after MIS-C resolved in the vast majority of children across cohorts (e.g., 98.3% in a Krakow cohort; all but one patient in the MUSIC cohort by 6 months). However, persistent GLS impairment was reported in 13–35.7% of selected cohorts at 6–12 months, and residual LGE on CMR in up to 33% of smaller studies, though the large MUSIC CMR analysis found only 3.5% met Lake Louise criteria at follow-up. Autonomic dysfunction (including POTS in 62.5% of one small retrospective cohort) contributed to persistent symptoms when conventional cardiac evaluation was normal.","limitations":"- Substantial heterogeneity in case definitions, follow-up timing, and diagnostic protocols prevents pooled estimates.\n- Most studies are single-centre with small samples; CMR and CPET often performed only in selected subgroups, introducing referral bias.\n- Long-term prognostic significance of isolated GLS or CMR abnormalities is unknown; no validated discharge criteria exist.","practice_takeaway":"Reserve ongoing cardiology surveillance for children with persistent objective cardiac abnormalities (ventricular dysfunction, arrhythmia, coronary aneurysm, elevated biomarkers); asymptomatic children with normal ECG, echo, and biomarkers at 4–6 weeks can be discharged from routine follow-up. Children with palpitations, orthostatic symptoms, or fatigue but normal conventional cardiac studies should be redirected to autonomic evaluation and rehabilitation rather than escalating cardiac imaging."}},{"doi":"10.1016/j.vaccine.2026.129001","pmid":"42607625","title":"Cardiac outcomes following SARS-CoV-2 infection versus BNT162b2 vaccination in adolescents and young adults: a cohort study of 4 million individuals","journal_title":"Vaccine","journal_issn":"0264-410X","published_at":"2026-08-17T00:00:00.000Z","url":"https://doi.org/10.2139/ssrn.6947525","source_score":24,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-27T06:17:04.087Z","updated_at":"2026-08-27T06:17:04.087Z","tags":[{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"age_group","value":"adolescent","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"brand","value":"Comirnaty","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"condition","value":"COVID-19","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"condition","value":"Myocarditis","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"condition","value":"Pericarditis","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"generic","value":"BNT162b2","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"modality","value":"mRNA Vaccine","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"sample_size","value":"n=4072375","value_numeric":4072375},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"warning","value":"Brand tag 'Comirnaty' is used as the proprietary name for BNT162b2 (Pfizer-BioNTech); the paper uses the generic name BNT162b2 throughout — no separate brand name is stated explicitly.","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"warning","value":"The all-cause mortality comparison is flagged by the authors themselves as descriptive rather than causal — clinicians should not interpret the mortality RR as a direct vaccine effect.","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"warning","value":"The hybrid immunity group (n=10,677) is notably small relative to other cohorts, so hybrid immunity findings should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1016/j.vaccine.2026.129001","tag_type":"warning","value":"The study spans December 2020–September 2025, encompassing multiple SARS-CoV-2 variant eras (original, Delta, Omicron); variant-specific risk estimates are not disaggregated, limiting applicability to current dominant strains.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study compared 6-month risks of myocarditis, pericarditis, and all-cause mortality between SARS-CoV-2 infection and BNT162b2 vaccination in 4,072,375 individuals aged 16–25 years, using TriNetX data from December 2020 to September 2025, with propensity-score matching and competing risk analysis.","key_result":"After 1:1 propensity-score matching, SARS-CoV-2 infection carried ~5× higher myocarditis risk (RR 4.91, 95% CI 3.11–7.77), ~2× higher pericarditis risk (RR 1.93, 95% CI 1.39–2.67), and higher all-cause mortality (RR 1.33, 95% CI 1.04–1.71) versus no infection; direct comparison showed vaccination was associated with 85% lower myocarditis risk, 79% lower pericarditis risk, and 72% lower mortality than infection, with an absolute risk difference of 0.0354% for myocarditis (1 fewer event per 2,827 vaccinated individuals).","limitations":"- Observational design using real-world EHR data (TriNetX) limits causal inference, particularly for all-cause mortality which the authors flag as descriptive only.\n- Outcome ascertainment depends on coded diagnoses, risking under- or misclassification of myocarditis and pericarditis.\n- The uninfected/unvaccinated reference group may include individuals with undetected prior infection, and study period spans multiple variant eras, complicating generalizability.","practice_takeaway":"In adolescents and young adults (16–25), documented SARS-CoV-2 infection carries substantially higher short-term cardiac and mortality risk than BNT162b2 vaccination, supporting the vaccine's favorable benefit-risk profile in this age group. Clinicians counseling hesitant patients or families can use the absolute numbers: vaccination was associated with roughly 1 fewer myocarditis case per ~2,800 individuals compared to infection."}},{"doi":"10.1038/s41541-026-01528-3","pmid":"42472854","title":"Multiorgan Outcomes Following BNT162b2 mRNA Vaccination vs SARS-CoV-2 Infection: A 30-Million-Person Real-World Cohort Analysis","journal_title":"npj Vaccines","journal_issn":"2059-0105","published_at":"2026-07-19T00:00:00.000Z","url":"https://doi.org/10.1038/s41541-026-01528-3","source_score":17,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-24T13:38:12.350Z","updated_at":"2026-07-24T13:38:12.350Z","tags":[{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"brand","value":"Comirnaty","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"condition","value":"Cerebrovascular Disease","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"condition","value":"COVID-19","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"condition","value":"Major Adverse Cardiovascular Events","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"condition","value":"Myocarditis","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"condition","value":"Pericarditis","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"condition","value":"Pulmonary Embolism","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"generic","value":"BNT162b2","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"modality","value":"mRNA Vaccine","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"sample_size","value":"n=30300000","value_numeric":30300000},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"warning","value":"Biological sex was used as the stratification variable; gender identity data were not available.","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"warning","value":"The >9-month window for vaccinated-only groups shows elevated mortality vs. controls (males RR 1.22, females RR 1.40), likely reflecting survivorship bias and healthy vaccinee effect reversal over time—this should not be interpreted as vaccine-caused late mortality.","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"warning","value":"The study is limited to BNT162b2 (Pfizer-BioNTech) and excludes Moderna, Janssen, AstraZeneca, and Novavax recipients, limiting generalizability across vaccine platforms.","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"warning","value":"Total cohort size of 30.3 million is reported in the abstract, but individual group sizes across supplemental tables sum to a smaller overlapping network; the effective denominators per comparison vary substantially.","value_numeric":null},{"paper_doi":"10.1038/s41541-026-01528-3","tag_type":"warning","value":"TriNetX suppresses event counts below 10 and reports them as '10' for de-identification, which may meaningfully inflate relative risks for rare outcomes (e.g., thrombosis with thrombocytopenia, ECMO use).","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study used the TriNetX US network (Dec 2020–Dec 2024) to compare 50 cardiovascular, cerebrovascular, and mortality outcomes across four mutually exclusive groups: unvaccinated/uninfected controls (n≈27M), SARS-CoV-2 infected/unvaccinated, BNT162b2-vaccinated only, and hybrid immunity (infected + vaccinated). Outcomes were tracked over four time windows (0–3, 3–6, 6–9, and >9 months), stratified by biological sex.","key_result":"SARS-CoV-2 infection drove 3- to 5-fold acute cardiovascular risk increases vs. controls, including myocarditis (males RR 4.44, females RR 5.59) and all-cause mortality (males RR 4.53), with elevated risk persisting beyond 9 months. BNT162b2 vaccination reduced MACE by 65–76% in the acute phase vs. controls. Completing the two-dose primary series cut mortality by 77% and myocarditis by 62% vs. one dose. Hybrid immunity added a 36–38% MACE reduction vs. infection alone; however, males with hybrid immunity showed late pericarditis elevation beyond 9 months (RR 1.80).","limitations":"- Observational design using EHR claims data prevents causal inference and is subject to residual confounding (e.g., unmeasured comorbidities, healthcare-seeking behavior).\n- TriNetX privacy threshold suppresses counts below 10, potentially inflating relative risks for rare events.\n- Study is BNT162b2-specific and limited to a US population; results may not generalize to other vaccines or settings.","practice_takeaway":"For patients weighing COVID-19 vaccination risks and benefits: infection carries far greater and more sustained cardiovascular harm than BNT162b2 vaccination across all sex and age groups. Completing the full two-dose primary series provides substantially more protection than a single dose—clinicians should continue to prioritize vaccination completion."}},{"doi":"10.1503/cmaj.260142","pmid":"42442795","title":"Tick-borne anaplasmosis and myocarditis in eastern Ontario","journal_title":"Canadian Medical Association Journal","journal_issn":"0820-3946","published_at":"2026-07-12T00:00:00.000Z","url":"https://doi.org/10.1503/cmaj.260142","source_score":206,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-16T13:37:22.736Z","updated_at":"2026-07-16T13:37:22.736Z","tags":[{"paper_doi":"10.1503/cmaj.260142","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"category","value":"Medicine, General & Internal","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"condition","value":"Anaplasmosis","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"condition","value":"Myocarditis","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"condition","value":"Tick-Borne Disease","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"generic","value":"doxycycline","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"modality","value":"Antibiotic","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"sample_size","value":"n=1","value_numeric":1},{"paper_doi":"10.1503/cmaj.260142","tag_type":"sex","value":"male","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"study_design","value":"Case Report","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"warning","value":"Anaplasmosis incidence figure cited (40 cases in Ontario) reflects a specific surveillance period and may not represent current rates.","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"warning","value":"Myocarditis was diagnosed by cardiac MRI without endomyocardial biopsy, so histopathologic confirmation is absent.","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"warning","value":"Single case report — findings should not be generalized without supporting evidence from larger studies.","value_numeric":null},{"paper_doi":"10.1503/cmaj.260142","tag_type":"warning","value":"The patient was on azathioprine (immunosuppressed), which may have contributed to disease severity; applicability to immunocompetent patients is uncertain.","value_numeric":null}],"summaries":{"what_studied":"A case report of a 79-year-old immunocompromised man from rural eastern Ontario who presented in July with fever, cytopenias, and multiorgan dysfunction. The case examines the clinical course, diagnostic workup, and treatment of *Anaplasma phagocytophilum* infection complicated by acute myocarditis.","key_result":"PCR-confirmed anaplasmosis with associated acute myocarditis (EF 43%, basal inferolateral LGE on cardiac MRI) resolved fully with 14 days of oral doxycycline 100 mg twice daily; repeat TTE at 4 months showed normalized ventricular function.","limitations":"- Single case report; cannot establish causation or generalizability.\n- Lumbar puncture was contraindicated due to thrombocytopenia, so CNS infection could not be fully excluded.\n- Endomyocardial biopsy was not performed; myocarditis diagnosis rests on clinical and cardiac MRI findings.","practice_takeaway":"In febrile patients from tick-endemic regions with thrombocytopenia, lymphopenia, and elevated transaminases — even without recalled tick exposure — start empiric doxycycline early and investigate for anaplasmosis. If cardiac symptoms or elevated troponin/BNP emerge, obtain echocardiography and cardiac MRI; myocarditis from anaplasmosis can resolve completely with appropriate antibiotic therapy."}},{"doi":"10.3389/fimmu.2026.1815269","pmid":null,"title":"Cardiovascular sequelae of Long COVID: immune dysregulation inflammation as central drivers","journal_title":"Frontiers in Immunology","journal_issn":"1664-3224","published_at":"2026-06-17T00:00:00.000Z","url":"https://doi.org/10.3389/fimmu.2026.1815269","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":false,"crossref":true,"unpaywall":true},"created_at":"2026-06-22T13:24:17.011Z","updated_at":"2026-06-22T13:24:17.011Z","tags":[{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"category","value":"Immunology","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"condition","value":"Arrhythmia","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"condition","value":"Heart Failure","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"condition","value":"Ischemic Heart Disease","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"condition","value":"Long COVID","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"condition","value":"Myocarditis","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"condition","value":"Thromboembolism","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"modality","value":"Immunomodulatory Therapy","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"warning","value":"No original patient data or sample size are reported — sample_size tag omitted.","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"warning","value":"Study design classified as 'Narrative Review' based on abstract and full-text structure; the paper does not explicitly label itself as such.","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"warning","value":"The publication date (2026) is in the future relative to most available evidence; some cited mechanistic findings may be preliminary or not yet fully replicated.","value_numeric":null},{"paper_doi":"10.3389/fimmu.2026.1815269","tag_type":"warning","value":"This is a narrative review; no systematic search strategy or PRISMA protocol is described, so selection bias in cited studies cannot be excluded.","value_numeric":null}],"summaries":{"what_studied":"This review examines the immune-mediated mechanisms driving cardiovascular sequelae in Long COVID (post-acute sequelae of SARS-CoV-2), including myocarditis, arrhythmias, heart failure, ischemic/non-ischemic heart disease, and thrombotic events, and explores potential therapeutic strategies targeting persistent inflammation and immune dysregulation.","key_result":"Persistent activation of both innate (pattern recognition receptors, NLRP3 inflammasome, neutrophil extracellular traps, complement system) and adaptive (T cell exhaustion, T cell subset imbalance with elevated TEMRA cells, aberrant B cell responses with abnormal IgG) immune pathways drives endothelial injury, thrombo-inflammation, and adverse myocardial remodeling in Long COVID.","limitations":"This is a narrative review without systematic search methods or meta-analysis; most cited mechanistic evidence comes from experimental or observational studies, limiting causal inference. No original patient data are presented.","practice_takeaway":"Clinicians managing Long COVID patients with cardiovascular symptoms should consider immune dysregulation and persistent inflammation as underlying drivers, and monitor for myocarditis, arrhythmias, thrombotic events, and heart failure. Therapeutic strategies targeting these immune pathways are under active investigation and may inform future treatment protocols."}},{"doi":"10.1200/jco-25-01647","pmid":"42296457","title":"Defining Cardiovascular Endpoints in Oncology Trials: Challenges and Opportunities: A Scientific Statement From the American Heart Association","journal_title":"Journal of Clinical Oncology","journal_issn":"0732-183X","published_at":"2026-06-15T00:00:00.000Z","url":"https://doi.org/10.1200/jco-25-01647","source_score":17,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-08T13:23:40.004Z","updated_at":"2026-08-08T13:23:40.004Z","tags":[{"paper_doi":"10.1200/jco-25-01647","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"category","value":"Oncology","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"condition","value":"Arrhythmia","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"condition","value":"Cancer","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"condition","value":"Cardiovascular Toxicity","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"condition","value":"Heart Failure","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"condition","value":"Myocarditis","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"condition","value":"Thromboembolism","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"modality","value":"Oncology Therapeutics","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"study_design","value":"Scientific Statement / Expert Consensus","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"warning","value":"No specific cancer drug classes, brands, or generics are evaluated; the framework is intentionally broad across all oncology therapeutics.","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"warning","value":"The paper was published in June 2026 and prospective validation of the proposed framework has not yet occurred as of the current date.","value_numeric":null},{"paper_doi":"10.1200/jco-25-01647","tag_type":"warning","value":"This is an expert consensus/scientific statement, not an original research study — no primary data or effect sizes are reported. Level of evidence is expert opinion (7).","value_numeric":null}],"summaries":{"what_studied":"This AHA scientific statement evaluates how cardiovascular (CV) endpoints should be selected, defined, and adjudicated in oncology clinical trials, covering toxicities across vascular, myocardial, and metabolic pathways from cancer therapies.","key_result":"The statement proposes a standardized framework linking drug-specific mechanisms to CV endpoint selection, harmonizing definitions for heart failure, arrhythmias, myocarditis, and thrombotic events, and aligning these with CTCAE grading and patient-reported outcomes.","limitations":"This is a consensus/expert statement without original trial data; recommendations are based on existing evidence and expert opinion, so the real-world impact on trial design and outcomes has not yet been prospectively validated.","practice_takeaway":"When designing or interpreting oncology trials, use mechanism-specific CV endpoint selection and standardized definitions (including MACE, surrogate endpoints, and CTCAE alignment) to improve detection and comparability of cardiovascular toxicity signals. Independent adjudication and pre-planned statistical approaches for competing risks and late-emerging toxicities should be built into trial protocols from the start."}},{"doi":"10.1002/ccd.70659","pmid":"42144794","title":"The Impact of COVID‐19 Infection and Vaccination on Myocarditis Incidence: A Comparative Analysis of Pre‐, Peri‐, and Post‐Pandemic Eras","journal_title":"Catheterization and Cardiovascular Interventions","journal_issn":"1522-1946","published_at":"2026-05-17T00:00:00.000Z","url":"https://doi.org/10.1002/ccd.70659","source_score":32,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-23T13:24:41.118Z","updated_at":"2026-05-23T13:24:41.118Z","tags":[{"paper_doi":"10.1002/ccd.70659","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ccd.70659","tag_type":"category","value":"Cardiac & Cardiovascular Systems","value_numeric":null},{"paper_doi":"10.1002/ccd.70659","tag_type":"condition","value":"COVID-19","value_numeric":null},{"paper_doi":"10.1002/ccd.70659","tag_type":"condition","value":"Myocarditis","value_numeric":null},{"paper_doi":"10.1002/ccd.70659","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1002/ccd.70659","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/ccd.70659","tag_type":"sample_size","value":"n=778","value_numeric":778},{"paper_doi":"10.1002/ccd.70659","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/ccd.70659","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1002/ccd.70659","tag_type":"warning","value":"ICD-10-based case ascertainment without confirmed endomyocardial biopsy or cardiac MRI criteria may affect case validity.","value_numeric":null},{"paper_doi":"10.1002/ccd.70659","tag_type":"warning","value":"The abstract does not report inpatient mortality rates with specific numbers despite listing it as an outcome — quantitative mortality comparisons across periods are unavailable from the provided text.","value_numeric":null},{"paper_doi":"10.1002/ccd.70659","tag_type":"warning","value":"Vaccine-associated myocarditis cases are mentioned as a study focus but are not broken out numerically in the abstract, limiting interpretation of vaccine vs. infection contribution.","value_numeric":null}],"summaries":{"what_studied":"A retrospective cohort study examined myocarditis incidence and inpatient mortality across 778 hospitalized patients in the MedStar Health System (Washington, DC area) from 2017–2024, comparing pre- (2017–2019), peri- (2020–2022), and post-COVID-19 (2023–2024) pandemic periods.","key_result":"Myocarditis hospitalizations surged during the peri-pandemic period (n=370) vs. pre-pandemic (n=207), peaking in 2022, then declined but remained elevated post-pandemic (n=201) — still above pre-pandemic levels. Peri- and post-pandemic patients were older, more likely to be African American, and carried greater cardiometabolic comorbidity burdens.","limitations":"- Single health system in one metro area limits generalizability.\n- Case identification relied on ICD-10 codes, which may misclassify or undercount true myocarditis.\n- Vaccine-associated vs. infection-associated myocarditis subgroups are not fully characterized in the abstract, and causality cannot be established from retrospective data.","practice_takeaway":"Myocarditis rates have not returned to pre-pandemic baselines even in 2023–2024; clinicians should maintain heightened awareness, especially in older patients and African American individuals with cardiometabolic risk factors. Further investigation into post-pandemic drivers — beyond direct COVID-19 infection and vaccination — is warranted."}},{"doi":"10.1097/inf.0000000000005109","pmid":"41398446","title":"Effectiveness and Safety of COVID-19 mRNA Vaccines in Children 6–17 Years Old: A Population-Based Study in Madrid","journal_title":"Pediatric Infectious Disease Journal","journal_issn":"0891-3668","published_at":"2025-12-16T00:00:00.000Z","url":"https://doi.org/10.1097/inf.0000000000005109","source_score":42,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2025-12-16","doi":"10.1097/inf.0000000000005109","days":"30","issn":"0891-3668","rank":"8","field":"Clinical Medicine","score":"42","category":"Infectious Diseases","categories":["Infectious Diseases"],"_categories":["Infectious Diseases"]},"pubmed":{"doi":"10.1097/INF.0000000000005109","title":"Effectiveness and Safety of COVID-19 mRNA Vaccines in Children 6-17 Years Old: A Population-Based Study in Madrid.","journal":"The Pediatric infectious disease journal","methods":"","results":"In 183,273 vaccinated and 916,365 controls 6-11 years old, the estimated risk difference (95% CI) of COVID-19 hospitalization was -1.2 per 100,000 (-6.6 to 4.0) for vaccinated versus controls; effectiveness 9.0% (-36 to 49). The risk difference of multisystem inflammatory syndrome in children was -1.4 per 100,000 (-4.7 to 2.3); effectiveness 27.0% (-54 to 76). No cases of myocarditis or pericarditis occurred. In 277,561 vaccinated and 1,387,805 controls 12-17 years old, the estimated risk difference of COVID-19 hospitalization was -5.3 per 100,000 (-9.0 to -2.0); effectiveness 45% (18-72). The risk difference of multisystem inflammatory syndrome in children was -1.3 per 100,000 (-3.0 to 0.8), effectiveness 42% (-31 to 83). The risk ratio of pericarditis/myocarditis for vaccinated versus controls was 1.09 (0.60-1.70).","abstract":"$30","keywords":["observational study","target trial emulation","vaccine effectiveness","vaccine safety"],"pubmed_id":"41398446","conclusions":"","publication_date":"2025-12-16T00:00:00"},"crossref":{"DOI":"10.1097/inf.0000000000005109","URL":"https://doi.org/10.1097/inf.0000000000005109","ISSN":["0891-3668","1532-0987"],"link":[{"URL":"https://journals.lww.com/10.1097/INF.0000000000005109","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Effectiveness and Safety of COVID-19 mRNA Vaccines in Children 6–17 Years Old: A Population-Based Study in Madrid"],"author":[{"given":"Miguel A.","family":"Hernán","sequence":"first","affiliation":[{"name":"CAUSALab, Departments of Epidemiology and Biostatistics, Harvard T.H. 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Madrid, Spain"}]},{"given":"José T.","family":"Ramos","sequence":"additional","affiliation":[{"name":"Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Universidad Complutense de Madrid, Madrid, Spain"},{"name":"Pediatric Infectious Diseases, Instituto de Investigación Sanitaria (i+12), Hospital Universitario 12 de Octubre, Madrid, Spain"}]},{"given":"José C.","family":"Estévez","sequence":"additional","affiliation":[{"name":"Gerencia Asistencial de Atención Primaria, Madrid, Spain"}]},{"given":"Miguel","family":"Basanta","sequence":"additional","affiliation":[{"name":"Dirección de Salud Digital, Madrid, Spain"}]},{"given":"Sergio","family":"Ruiz","sequence":"additional","affiliation":[{"name":"Gerencia Asistencial de Atención Primaria, Madrid, Spain"}]},{"given":"Ángel L.","family":"Matáix","sequence":"additional","affiliation":[{"name":"Subdirección General de Farmacia y Productos Sanitarios, 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M.","family":"Molero","sequence":"additional","affiliation":[{"name":"Centro de Salud San Andrés, Madrid, Spain."}]},{"given":"Juan","family":"Berenguer","sequence":"additional","affiliation":[{"name":"Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain"},{"name":"Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain"},{"name":"Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, 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Outcomes were COVID-19 hospitalization, MIS-C, and myocarditis/pericarditis, with effectiveness defined as 1 minus the risk ratio.","key_result":"Ages 6–11: COVID-19 hospitalization risk difference −1.2 per 100,000 (95% CI −6.6 to 4.0), effectiveness 9% (−36 to 49); MIS-C risk difference −1.4 per 100,000 (−4.7 to 2.3), effectiveness 27% (−54 to 76); no myocarditis/pericarditis cases. Ages 12–17: COVID-19 hospitalization risk difference −5.3 per 100,000 (−9.0 to −2.0), effectiveness 45% (18 to 72); MIS-C risk difference −1.3 per 100,000 (−3.0 to 0.8), effectiveness 42% (−31 to 83); myocarditis/pericarditis risk ratio 1.09 (0.60 to 1.70).","practice_takeaway":"In this large Madrid cohort, absolute benefits of mRNA vaccination in children were small, with a clearer reduction in hospitalization among adolescents. MIS-C reductions were small, and there was no myocarditis signal in 6–11 years and no clear increase in 12–17 years over 240 days."}},{"doi":"10.1016/s2352-4642(25)00247-0","pmid":"41198364","title":"Vascular and inflammatory diseases after COVID-19 infection and vaccination in children and young people in England: a retrospective, population-based cohort study using linked electronic health records","journal_title":"The Lancet Child & Adolescent Health","journal_issn":"2352-4642","published_at":"2025-11-07T00:00:00.000Z","url":"https://doi.org/10.1016/s2352-4642(25)00247-0","source_score":2507,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-02","doi":"10.1016/s2352-4642(25)00247-0","days":"30","issn":"2352-4642","rank":"1","field":"Clinical Medicine","score":"2507","category":"Pediatrics","categories":["Pediatrics"],"_categories":["Pediatrics"]},"pubmed":{"doi":"10.1016/S2352-4642(25)00247-0","title":"Vascular and inflammatory diseases after COVID-19 infection and vaccination in children and young people in England: a retrospective, population-based cohort study using linked electronic health records.","journal":"The Lancet. 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given.","value_numeric":null},{"paper_doi":"10.1016/s2352-4642(25)00247-0","tag_type":"warning","value":"The category ‘inflammatory conditions’ is broad and not defined in the abstract, making clinical interpretation less specific.","value_numeric":null},{"paper_doi":"10.1016/s2352-4642(25)00247-0","tag_type":"warning","value":"Vaccination analyses apply to ages 5 to <18 years and to BNT162b2 only, which may limit generalizability to other vaccines or age bands.","value_numeric":null}],"summaries":{"what_studied":"A retrospective, population-based cohort of all individuals in England younger than 18 years (Jan 1, 2020–Dec 31, 2022) evaluated risks of arterial/venous thrombosis, thrombocytopenia, myocarditis/pericarditis, and inflammatory conditions after first COVID-19 diagnosis and after first BNT162b2 vaccination, compared with time before or without these exposures.","key_result":"In the first week after COVID-19 diagnosis, adjusted hazard ratios (aHRs) were higher for arterial thromboembolism 2.33 (95% CI 1.20–4.51), venous thromboembolism 4.90 (3.66–6.55), thrombocytopenia 3.64 (2.21–6.00), myocarditis/pericarditis 3.46 (2.06–5.80), and inflammatory conditions 14.84 (11.01–19.99); elevated risks for venous thromboembolism 1.39 (1.14–1.69), thrombocytopenia 1.42 (1.01–2.00), and myocarditis/pericarditis 1.42 (1.05–1.91) persisted beyond 12 months. After first BNT162b2 vaccination, myocarditis/pericarditis risk was elevated within 4 weeks (aHR 1.84 [1.25–2.72]); 6‑month absolute excess risk for myocarditis/pericarditis was 2.24 (1.11–3.80) per 100,000 after diagnosis versus 0.85 (0.07–1.91) after vaccination.","practice_takeaway":"In children and young people, SARS‑CoV‑2 infection increases rare vascular and inflammatory events, with some risks persisting beyond a year, while BNT162b2 vaccination carries a smaller, short‑term myocarditis/pericarditis risk. These data support vaccination to mitigate the more frequent and longer‑lasting risks from infection."}}],"initialOffset":12,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Myocarditis"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Myocarditis"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Myocarditis"}}}]]

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