Myocarditis, good news

well and welcome to today's talk Sunday the 6th of November now we're going to be looking at a small study today shouldn't take too long but it's very important and it's from Israel before vaccination for covid-19 was introduced and what it did it looked at a large cohort of people who'd had covered diagnosed by PCR a large group of people as a control that had not had covid who never had symptoms and tested negative on PCR and they compared the incidence of myocarditis and pericarditis between the two groups and he followed them up for four five six months the the average follow-up was about 4.1 months I think but very substantial follow-up and what they found is there was no difference between the groups so the covert group did not have more myocarditis and pericarditis than the group who'd never had the covert infections and this is completely regardless of the vaccination it's before the vaccinations were being were introduced now why don't more countries look at similar studies because we've got large cohorts of people who had covered and didn't have covered before there was vaccination it's such an obvious study to do and there's groups this these groups in Israel have done it from University of Tel Aviv and Jerusalem to Maine Medical universities in Israel now we are seeing more pericarditis and myocarditis around at the moment so from this data it would appear from this data that the source of this increased amount of myocarditis and pericarditis is not covert infection per se not the covet infection itself and I think you can see the import of that statement that I've just made now don't take my word let's look at the data uh this is the study here incidence of myocarditis and pericarditis and post-covered unvaccinated patients a large population-based study and we'll see it is a very large very large study indeed well conducted journal of clinical medicine check it out for yourself four things there you can download the PDF um very substantial peer-reviewed Journal um myocarditis and pericarditis post-acute cardiac sequelae it also means that this is probably not a cause of many cases of long covered as well so the people that are suffering from cardiac conditions that people have assumed was caused by covert this data would indicate might not be caused by the covert infection itself therefore we need to look for an alternative cause or another cause or cause is of the pericarditis and myocarditis that is around you can see why this study is so important we need to be looking for other causes we always need to know the cause of disease the etiology of disease so the immune response as we know can potentially cause inflammation of the heart what is the incidence is what they set out to found to find looking for what the incidence was and of course they found out it was no greater than the other groups retrospective cohort study looking back to the pre-vaccination days so the pandemic was well underway in early 2020 but vaccination hadn't started a study group who'd had the infection 196 1992 so pretty like this from the clay at Health Services in Israel so a large amount had the infection so they're the study group pretty large number impressive data sets now uh March 2020 to January 2021. now what they actually recorded was inpatient myocarditis and pericarditis diagnosis now these were patients that were bad enough to go to hospital to get their condition checked out and if some 10 days after a positive PCR and as we said an ongoing follow-up Israel vaccination programs initiated on the 20th of December so what they actually did was they took patients who'd reported up to the 15th of December they left five clear days so they're comparing patients who'd had covered pre-vaccination period patients who had not had covered pre-vaccination period comparing like with like that's good scientific comparisons follow-up um data worlds so but we'll leave that bit it was centered on the 20 third 21st of February but the point is they didn't take patients after the vaccines were introduced now covered cohort who were never infected so remember the infected cohort was just under 200 000 wasn't it uh there it is 196 922 so that was the uh patients who had it they compared those against the larger group over half a million who hadn't these are the sort of numbers that researchers dream of you get very very good data from these kind of numbers and of course it wasn't a selected group they just took everyone from the health group they just took the lot that they're able to get large sample numbers with at least one negative PCR test no positive PCR test so these people hadn't had it they adjusted for age and sex and of course they looked at other things they looked at a body mass index and uh smoking and other things that were associated with heart disease they're well aware of all these factors as we say calculated backwards from the 15th of December so what are the results right the post covert group the patients that had had covered nine patients developed myocarditis that's 0.046. in the patients I'd had it um 11 were diagnosed with pericarditis that's 0.056 now remember this is in the follow-up period people who actually have covered can get cardiac complications at the time in the acute condition that can happen this is in the follow-up period not in the acute period the follow-up period so there we see it 0.046 developed myocarditis 0.056 developed um pericarditis who'd had covered the ones that had never had covered 27 developed myocarditis which was exactly the same note point not not four six coincidentally it was exactly the same and uh people who'd never had covert actually developed slightly more pericarditis 0.08 and they put in these P values so that p-value one there that p-value of one basically what it means is there is no chance at all that this result could have Arisen by chance they are absolutely certain that this this is a genuine result it couldn't have Arisen by chance the p-value was one there was no difference no significant difference at all between the groups and that p-value there's 0.17 so again basically no difference between the group so we're going to need to go down to 0.05 before there was a difference so there you go I mean that is really quite uh impressively after infections 0.046 had myocarditis 0.046 had myocarditis with no infection in other words they these are just the the sort of people that would get it anyway and if anything um never having covered was protective enough we're not saying that of course um but but but it's certainly true that more people had it in that group therefore The increased incidence of pericarditis and myocarditis must be caused by other factors from this Israeli data let's look at the graphs here actually pretty interesting as well myocarditis so no covid had covered so we see that um the no covert group actually ended up a bit above the actually a bit above the uh the covert group um it had been in the other way you can see it's just varied I think these are just attributable to noise basically we're saying there's no difference between these two groups in terms of follow-up over the six month period here in terms of the risk of myocarditis inflammation of the heart muscle for pericarditis again if anything we see that Peterson that didn't have covered was slightly that they had slightly less you know they're a different incident so basically I mean we're not we're not saying there's a statistical difference there's no statistical difference here really because the p-value is 0.17 so basically we're not there's no significant difference between these two groups it really is quite a profound result really I just it has a ratio no so what were the risks well men developed a lot more than women these are all over 18. so uh men were nearly four and a half times more likely to develop myocarditis than women and of course you might remember that some of the early studies of this were done in the U.S military and the male population there predominated so that could have skewed the American Military results just looking back that's possible um so men more likely to get myocarditis regardless of whether it had covid-19 or not that didn't make a difference but male sex did increase the risk pericarditis men almost twice as likely again Hazard ratio of 1.93 93 more likely to get it and people with peripheral vascular disease just over four times more likely to get it not surprising disease of the blood vessels so there's something going on in the circulatory system there anyway follow-up median 4.4 months 700 000 person months in the covert group um to 2.1 million in the non-cover group excellent very large very large sample sizes so the conclusion post covid-19 infection was not associated with myocarditis post-covered 19 infection was not associated with pericarditis from the Israeli data the author's comment we did not observe an increase an increased incidence of neither pericarditis nor myocarditis in adult patients recovering from covid-19 infection our data suggests there is no increase in the incidence of myocarditis and pericarditis and covid-19 recovered patients compared with uninfected matched controls this of course is remarkably good news from the Israeli data covid-19 is not causing long-term myocarditis and pericarditis very very good news yet we do have more myocarditis and pericarditis but it looks like the cause is not um the actual coveted infection I'm going to leave that there thank you for watching

Channel: Dr. John Campbell

Views: 478,785

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: RMMA9bwDklQ

Length: 11min 32sec (692 seconds)

Published: Sun Nov 06 2022