Authors' objectives: To determine: Whether acute COVID-19 infection increase a person's risk of acute perimyocarditis or myopericarditis. Whether previous COVID-19 infection (in general) increase a person's risk of acute perimyocarditis or myopericarditis. Whether there is any (causal) association between development of perimyocarditis or myopericarditis and COVID-19 infection.

Authors' results and conclusions: Five hundred eighty-four published studies were identified from the literature search. Of these, 96 studies were thought to be relevant and were retrieved in full of which 32 were deemed not relevant or provided enough data to be discussed further. Eight studies were in the form of expert/systematic review on which we traced the relevant primary studies included in these review articles which were not discussed in this review which left 56 studies which were included in this review. Of the 56 studies included in this systematic review, 49 primary studies were in the form of case report (level of evidence 4. Appendix 1) and five primary studies were in the form of small case series (n=11,2,5,5 and 49 patients, respectively). Although these 54 primary studies provided evidence on the temporality of the development of perimyocarditis or myopericarditis post SARS-Cov2 infection, it should be noted that it is not clear how these cases were selected and presented, and it is not clear what was the role other risk factors of perimyocarditis/myopericarditis played in the development of the disease. At present, there is some evidence that COVID-19 infection and potentially post-COVID 19 infection was associated with the development of perimyocarditis/myopericarditis. At present, there is some evidence (level of evidence 3) that Covid-19 infection increased the risk of developing perimyocarditis/myopericarditis. However, this evidence must be interpreted with caution since chance, bias and confounding cannot be excluded from potentially affecting the observed association. Regarding causality, at present, there is some evidence on the temporality and biological plausibility of the association. However, regarding the size of the association, consistency and specificity, more evidence needs to be developed.

Authors' methods: A comprehensive and systematic literature search was conducted on April 19, 2024. The search was done on commercial medical literature databases. Combination of keywords were employed in this literature search. No limitation, such as on the language or country of publication, was implemented in the literature search. It should be noted though that due to the topic of this systematic review was on Covid-19, the literature was “self-selected” to those published in or after 2019. A manual search was done on the references of the articles that were retrieved in full. Of the expert/systematic review articles identified in the literature search, we traced and retrieved the relevant primary studies included in these review articles and subsequently excluded these review articles in our critical appraisal.

Project Status: Completed

URL for project: https://www.worksafebc.com/en/about-us/research-services/evidence-based-medicine-and-systematic-reviews

Year Published: 2024

URL for published report: https://www.worksafebc.com/en/resources/health-care-providers/guides/covid-19-perimyocarditis?lang=en&origin=s&returnurl=https%3A%2F%2Fwww.worksafebc.com%2Fen%2Fforms-resources%23sort%3DDate%26q%3DCOVID-19%2520and%2520Perimyocarditis%26f%3Alanguage-facet%3D%5BEnglish%5D%26tags%3DGuide%7C2d7eb4b30f6a4a319e0d40565c9abbab%2CHealth%2520Care%2520Provider%7C13468b0b3f074f6bade3f57ac3cdfb8e%2CSystematic%2520Review%7Cf78c29d570c14ec3b5a394385905df70&highlight=COVID-19%20and%20Perimyocarditis

English language abstract: An English language summary is available

Publication Type: Mini HTA

Country: Canada

Organisation Name: WorkSafeBC

Contact Address: 6591 Westminster Highway, Richmond, BC, V7C 1C6 Canada. Tel: 604-231-8417; Fax: 604-279-7698

Contact Name: ebpg@worksafebc.com

Contact Email: ebpg@worksafebc.com

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