(Prost dostop.)
Eur. J. Pediat. 2023, Jan. 5; 1-8. doi: 10.1007/s00431-022-04786-0.
Spremembe parametrov EKG po cepivu BNT162b2 pri dijakih višjih letnikov
(Changes of ECG parameters after BNT162b2 vaccine in the senior high school students)
Povzetek (Googletranslate):
“Med 7934 upravičenimi študenti jih je bilo v študijo vključenih 4928 (62,1 %). Razmerje med moškimi in ženskami je bilo 4576/352. Skupno je imelo 763 študentov (17,1 %) vsaj en srčni simptom po drugem odmerku cepiva, večinoma bolečine v prsih in palpitacije.”
Namen te študije je bil ugotoviti spremembo EKG parametrov in učinkovitost EKG presejanja za srčne neželene učinke po drugem odmerku cepiva BNT162b2 pri mladi populaciji. Decembra 2021 smo v sodelovanju s šolskim sistemom cepljenja vlade mesta Taipei izvedli presejalno študijo EKG med drugim odmerkom cepiv BNT162b2. Serijske primerjave EKG in vprašalnika so bile izvedene pred in po cepljenju v štirih srednjih šolah, v katerih so pretežno moški. Med 7934 upravičenimi študenti jih je bilo v študijo vključenih 4928 (62,1 %). Razmerje med moškimi in ženskami je bilo 4576/352. Skupno je imelo 763 študentov (17,1 %) vsaj en srčni simptom po drugem odmerku cepiva, večinoma bolečine v prsih in palpitacije. Depolarizacijski in repolarizacijski parametri (trajanje QRS in interval QT) so se po cepivu z naraščajočo srčno frekvenco pomembno zmanjšali. Nenormalni EKG so bili pridobljeni pri 51 (1,0 %) študentov, od katerih je bil 1 diagnosticiran z blagim miokarditisom, drugi 4 pa so imeli pomembno aritmijo. Nobenega od bolnikov ni bilo treba sprejeti v bolnišnico in vsi ti simptomi so se spontano izboljšali. Če uporabimo teh pet študentov kot pozitiven rezultat, sta bili občutljivost in specifičnost te presejalne metode 100 % oziroma 99,1 %. Zaključek: Srčni simptomi so pogosti po drugem odmerku cepiva BNT162b2, vendar je incidenca pomembnih aritmij in miokarditisa le 0,1 %. Metoda serijskega presejanja EKG ima visoko občutljivost in specifičnost za pomembne neželene učinke na srce, vendar je treba dodatno razpravljati o stroškovnem učinku.
Kaj je znano:
• Na podlagi sistema poročanja je bila pojavnost neželenih učinkov na srce po drugem odmerku cepiva BNT162b2 proti COVID-19 pri mladi moški populaciji kar 1,5 na 10 000 oseb.
Kaj je novega:
• S to množično presejalno študijo EKG po drugem odmerku cepiva BNT162b2 smo ugotovili: (1) Parametri depolarizacije in repolarizacije (trajanje QRS in interval QT) so se po cepivu znatno zmanjšali z naraščajočim srčnim utripom; (2) incidenca miokarditisa po cepljenju in pomembne aritmije je 0,02 % in 0,08 %; (3) Metoda serijskega presejanja EKG ima visoko občutljivost in specifičnost za pomembne neželene učinke na srce.
Abstract:
“Among 7934 eligible students, 4928 (62.1%) were included in the study. The male/female ratio was 4576/352. In total, 763 students (17.1%) had at least one cardiac symptom after the second vaccine dose, mostly chest pain and palpitations.”
The purpose of this study is to determine the ECG parameter change and the efficacy of ECG screening for cardiac adverse effect after the second dose of BNT162b2 vaccine in young population. In December 2021, in cooperation with the school vaccination system of Taipei City government, we performed a ECG screening study during the second dose of BNT162b2 vaccines. Serial comparisons of ECGs and questionnaire survey were performed before and after vaccine in four male-predominant senior high schools. Among 7934 eligible students, 4928 (62.1%) were included in the study. The male/female ratio was 4576/352. In total, 763 students (17.1%) had at least one cardiac symptom after the second vaccine dose, mostly chest pain and palpitations. The depolarization and repolarization parameters (QRS duration and QT interval) decreased significantly after the vaccine with increasing heart rate. Abnormal ECGs were obtained in 51 (1.0%) of the students, of which 1 was diagnosed with mild myocarditis and another 4 were judged to have significant arrhythmia. None of the patients needed to be admitted to hospital and all of these symptoms improved spontaneously. Using these five students as a positive outcome, the sensitivity and specificity of this screening method were 100% and 99.1%, respectively. Conclusion: Cardiac symptoms are common after the second dose of BNT162b2 vaccine, but the incidences of significant arrhythmias and myocarditis are only 0.1%. The serial ECG screening method has high sensitivity and specificity for significant cardiac adverse effect but cost effect needs further discussed. What is Known: • The incidence of cardiac adverse effects was reported to be as high as 1.5 per 10 000 persons after the second dose BNT162b2 COVID-19 vaccine in the young male population based on the reporting system. What is New: • Through this mass ECG screening study after the second dose of BNT162b2 vaccine we found: (1) The depolarization and repolarization parameters (QRS duration and QT interval) decreased significantly after the vaccine with increasing heart rate; (2) the incidence of post-vaccine myocarditis and significant arrhythmia are 0.02% and 0.08%; (3) The serial ECG screening method has high sensitivity and specificity for significant cardiac adverse effect.
Povezava na objavo na Pub.Med.gov.:
https://pubmed.ncbi.nlm.nih.gov/36602621/