Table of ContentsView AllTable of ContentsPericarditis and COVIDLong-COVID EffectsHow Soon It OccursPericarditis and COVID HospitalizationTreatmentLiving With Long COVID
Table of ContentsView All
View All
Table of Contents
Pericarditis and COVID
Long-COVID Effects
How Soon It Occurs
Pericarditis and COVID Hospitalization
Treatment
Living With Long COVID
Infection with the virus that causes COVID-19 increases a person’s risk for heart-related complications, includingpericarditis(inflammation of the heart’s outer lining) andmyocarditis(inflammation of the heart muscle).
Receiving aCOVID-19 vaccinehas also been associated, albeit rarely, with potential adverse heart-related effects, namely myocarditis and pericarditis.
Though pericarditis and myocarditis are both inflammatory heart conditions and can coexist (calledmyopericarditis), this article focuses mainly on the link between pericarditis and the COVID-19 infection and vaccine.
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Facts About Pericarditis and COVID-19
Pericarditis causes sharp or stabbingchest pain that worsens with breathingand typically improves when sitting up or leaning forward.
There are multiple potential causes of pericarditis, including viral infections like COVID-19, as well as autoimmune diseases (e.g.,lupus), cancer, and kidney failure.
How COVID-19 Causes Pericarditis
In addition to COVID-19 infection possibly causing pericarditis, rare cases of pericarditis have been observed after receiving the COVID-19 vaccine.Specifically, research has also found a causal link between pericarditis and themRNACOVID-19 vaccines,Pfizer-BioNTechandModerna.
Moreover, findings from clinical studies and vaccine safety monitoring outside of the United States suggest an elevated risk of pericarditis after receiving theNovavax vaccine, a protein-based vaccine.
Types of COVID-19 Vaccines
Heart-related conditions, including pericarditis, are a potential consequence of COVID-19 infection.
In males, results revealed the incidence of myocarditis or pericarditis seven to 21 days after infection to be:
In females, the results included:
This article uses the terms for sex or gender from the cited studies and sources. In those sources, they generally pertain to sex assigned at birth.
What Exactly Do Incidence and Prevalence Mean?
The development of pericarditis (and myocarditis) after receiving the COVID-19 vaccine is very rare but has still been reported more often than expected.A study that analyzed data from 40 healthcare systems in the United States (same as above) found the incidence of pericarditis or myocarditis after themRNA COVID-19 vaccineto be the following across all age groups and after any vaccine dose:
For males:
For females:
SummaryCurrent research has found that the risk of pericarditis is significantly higher after a COVID-19 infection than after an mRNA COVID-19 vaccination for males and females in all age groups.
Summary
Current research has found that the risk of pericarditis is significantly higher after a COVID-19 infection than after an mRNA COVID-19 vaccination for males and females in all age groups.
Regarding pericarditis from theNovavax COVID-19 vaccine, data is scant, and more investigation is required, although cases have been reported in the United States and worldwide.
Highest-Risk Groups
In a review article collecting data from 33 studies, COVID-19-related pericarditis was found to affect individuals at any age and be twice as common in males compared to females.
Regarding the COVID-19 vaccines, an increased risk for pericarditis was observed among individuals—particularly adolescent and young adult males—within seven days after receiving the second dose of anmRNA COVID-19 vaccine.
Data is still limited regarding links between pericarditis and the Novavax vaccine. However, one study analyzing reports to the World Health Organization (WHO) found that most cases of myopericarditis after theNovavax vaccineinvolved males with a median age of 35.5 years.
Similar to the mRNA vaccines, most cases of pericarditis also occurred after the second Novavax vaccine dose.
Long COVID Effects on Heart and Body
COVID-19 infection can present itself in many different ways, ranging from no symptoms to a mild cold to severe illness, includingrespiratory failure(the inability to breathe on your own) and multiple organ failure.
Though most people with COVID-19 fully recover, a significant number of affected individuals experience long-term health complications—what’s known aslong COVIDor post-COVID-19 syndrome.
Symptoms of long COVID-19 may start during or after the acute illness and can last for weeks, months, or even years.
Possible heart-related manifestations of long COVID-19 include:
Mild COVID Can Trigger Heart Disease One Year After Infection
Other examples of potential long COVID-19 health manifestations include:
Emergency Pericarditis and Myocarditis Symptoms
The most commonly reported symptoms of pericarditis associated with COVID-19 infection are:
Other reported symptoms include cough, fatigue, muscle aches, and diarrhea.
Symptoms in Young ChildrenAccording to the CDC, young children with pericarditis (or myocarditis) may have irritability, vomiting, poor feeding, rapid breathing, or lethargy.
Symptoms in Young Children
According to the CDC, young children with pericarditis (or myocarditis) may have irritability, vomiting, poor feeding, rapid breathing, or lethargy.
According to the American Heart Association, individuals should seek immediate medical attention for the following symptoms:
How Soon After COVID Does Pericarditis Occur?
Pericarditis may develop when a person is acutely ill with COVID-19 or after they have recovered from the infection.
Specifically, one study reported that in people with COVID-19-related pericarditis, the condition was diagnosed between five and 56 days after infection.
Another study of people who had received the COVID-19 vaccination found an increased risk of pericarditis in the one to 28 days following a positive COVID-19 test.
Cases of pericarditis after receiving theModerna or Pfizer-BioNTech COVID-19 vaccinemost commonly developed within seven days after receiving the second dose.
Minimal data regarding pericarditis after theNovavax vaccinesuggest a timeline similar to that of the mRNA vaccines, with symptom onset beginning eight to 10 days after the second dose.
Scientific data has found that the incidence of pericarditis developing in people with COVID-19 who are hospitalized is less than 0.5%.
That said, people hospitalized with COVID-19-induced pericarditis have highermortality(death) rates than those hospitalized with COVID-19 without pericarditis.
Moreover, hospitalized people infected with COVID-19 with pericarditis were more likely to stay in the hospital longer. They also had a higher chance of developing complications, namelycardiac arrestandacute kidney injury.
Treatment for COVID-Induced Pericarditis
There is no defined or predominant strategy for treating COVID-19-induced pericarditis, although any treatment aims to ease the inflammation of the pericardium and alleviate symptoms, namely chest pain.
Studies of COVID-19-induced pericarditis found that most affected individuals were safely and effectively treated to reduce inflammation withcolchicine, anonsteroidal anti-inflammatory drug (NSAID), or a combination of these drugs.
The NSAIDs typically used were:
Less commonly,corticosteroids(“steroids”), which also work to reduce inflammation, were used.
Interventional therapies were only implemented when people developedcardiactamponade, a complication of pericarditis wherein extra fluid collects around the heart, impairing the heart’s function.
The treatment of cardiac tamponade involves urgent draining of the excess fluid surrounding the heart, which is usually performed using a needle or, less commonly, surgery.
Living With Long COVID Complications
The complications of long COVID are diverse and sometimes debilitating. To best cope, experts recommend devising a personalized care plan under the guidance of one or more healthcare providers.
In addition to managing physical symptoms (e.g., intense fatigue, breathlessness, and muscle pain, among many possible others), it’s also important to acknowledge the various emotional challenges of living with long COVID. You might feel anger, frustration, or anxiety over the impact this illness has had on your daily functioning and quality of life.
To combat negative feelings and thoughts, reach out to trusted friends, family members, or colleagues for comfort. Also, talk with a healthcare provider because you may benefit from medication or a referral to atherapist.
Have Long COVID and Can’t Work? Here’s What to Do
Pericarditis—the inflammation of the tissue surrounding the heart—can develop during an acute COVID-19 infection or after recovery. Other heart-related consequences of COVID-19 include myocarditis, heart failure, heart attack, and arrhythmia.
Pericarditis may also rarely occur following receipt of an mRNA COVID-19 vaccine (Moderna or Pfizer-BioNTech), with the risk being highest in adolescent and young adult males after receiving the second dose. Data regarding the risk of pericarditis from the Novavax protein-based vaccine is still emerging.
Overall, experts have found that the risk of pericarditis is higher from getting infected with COVID-19 than receiving the COVID-19 vaccine for people of any sex across all age groups. As such, the CDC recommends staying up to date on COVID-19 vaccination for all eligible individuals.
17 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Terzic CM, Medina-Inojosa BJ.Cardiovascular complications of coronavirus disease—2019.Phys Med Rehabil Clin N Am. 2023;34(3):551-561. doi:10.1016/j.pmr.2023.03.003Gargano JW, Wallace M, Hadler SC, et al.Use of mRNA COVID-19 vaccine after reports of myocarditis among vaccine recipients: update from the Advisory Committee on Immunization Practices — United States, June 2021.MMWR Morb Mortal Wkly Rep. 2021;70(27):977-982. doi:10.15585/mmwr.mm7027e2National Heart, Lung, and Blood Institute.Pericarditis.Theetha Kariyanna P, Sabih A, Sutarjono B, et al.A systematic review of COVID-19 and pericarditis.Cureus. 2022;14(8):e27948. doi:10.7759/cureus.27948Centers for Disease Control and Prevention.Interim clinical considerations for use of COVID-19 vaccines in the United States.Block JP, Boehmer TK, Forrest CB, et al.Cardiac complications after SARS-CoV-2 infection and mRNA COVID-19 vaccination — PCORnet, United States, January 2021–January 2022.MMWR Morb Mortal Wkly Rep. 2022;71(14):517-523. doi:10.15585/mmwr.mm7114e1Macías Saint-Gerons D, Ibarz MT, Castro JL, et al.Myopericarditis associated with the Novavax COVID-19 vaccine (NVX-CoV2373): a retrospective analysis of individual case safety reports from VigiBase.Drugs Real World Outcomes. 2023;10(2):263-270. doi:10.1007/s40801-023-00355-5U.S. Food and Drug Administration.Novavax COVID-19 vaccine (NVX-CoV2373) VRBPAC briefing document.Parotto M, Gyöngyösi M, Howe K, et al.Post-acute sequelae of COVID-19: understanding and addressing the burden of multisystem manifestations.Lancet Respir Med. 2023 Aug;11(8):739-754. doi:10.1016/S2213-2600(23)00239-4Centers for Disease Control and Prevention.Clinical considerations: myocarditis and pericarditis after receipt of COVID-19 vaccines among adolescents and young adults.American Heart Association.COVID-19 vaccine benefits still outweigh risks, despite possible rare heart complications.Centers for Disease Control and Prevention.Myocarditis and pericarditis after mRNA COVID-19 vaccinationDiaz-Arocutipa C, Saucedo-Chinchay J, Imazio M.Pericarditis in patients with COVID-19: a systematic review.J Cardiovasc Med (Hagerstown). 2021;22(9):693-700. doi:10.2459/JCM.0000000000001202Patone M, Mei XW, Handunnetthi L, et al.Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection.Nat Med. 2022;28(2):410-422. doi:10.1038/s41591-021-01630-0Li P, Shi A, Lu X, et al.Incidence and impact of acute pericarditis in hospitalized patients with COVID-19.J Am Heart Assoc. 2023;12(20):e028970. doi:10.1161/JAHA.122.028970Jensen JK, Poulsen SH, Mølgaard H.Cardiac tamponade: a clinical challenge.E-Journal of Cardiology Practice. 2017;15.Centers for Disease Control and Prevention.Long COVID or post-COVID conditions.
17 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Terzic CM, Medina-Inojosa BJ.Cardiovascular complications of coronavirus disease—2019.Phys Med Rehabil Clin N Am. 2023;34(3):551-561. doi:10.1016/j.pmr.2023.03.003Gargano JW, Wallace M, Hadler SC, et al.Use of mRNA COVID-19 vaccine after reports of myocarditis among vaccine recipients: update from the Advisory Committee on Immunization Practices — United States, June 2021.MMWR Morb Mortal Wkly Rep. 2021;70(27):977-982. doi:10.15585/mmwr.mm7027e2National Heart, Lung, and Blood Institute.Pericarditis.Theetha Kariyanna P, Sabih A, Sutarjono B, et al.A systematic review of COVID-19 and pericarditis.Cureus. 2022;14(8):e27948. doi:10.7759/cureus.27948Centers for Disease Control and Prevention.Interim clinical considerations for use of COVID-19 vaccines in the United States.Block JP, Boehmer TK, Forrest CB, et al.Cardiac complications after SARS-CoV-2 infection and mRNA COVID-19 vaccination — PCORnet, United States, January 2021–January 2022.MMWR Morb Mortal Wkly Rep. 2022;71(14):517-523. doi:10.15585/mmwr.mm7114e1Macías Saint-Gerons D, Ibarz MT, Castro JL, et al.Myopericarditis associated with the Novavax COVID-19 vaccine (NVX-CoV2373): a retrospective analysis of individual case safety reports from VigiBase.Drugs Real World Outcomes. 2023;10(2):263-270. doi:10.1007/s40801-023-00355-5U.S. Food and Drug Administration.Novavax COVID-19 vaccine (NVX-CoV2373) VRBPAC briefing document.Parotto M, Gyöngyösi M, Howe K, et al.Post-acute sequelae of COVID-19: understanding and addressing the burden of multisystem manifestations.Lancet Respir Med. 2023 Aug;11(8):739-754. doi:10.1016/S2213-2600(23)00239-4Centers for Disease Control and Prevention.Clinical considerations: myocarditis and pericarditis after receipt of COVID-19 vaccines among adolescents and young adults.American Heart Association.COVID-19 vaccine benefits still outweigh risks, despite possible rare heart complications.Centers for Disease Control and Prevention.Myocarditis and pericarditis after mRNA COVID-19 vaccinationDiaz-Arocutipa C, Saucedo-Chinchay J, Imazio M.Pericarditis in patients with COVID-19: a systematic review.J Cardiovasc Med (Hagerstown). 2021;22(9):693-700. doi:10.2459/JCM.0000000000001202Patone M, Mei XW, Handunnetthi L, et al.Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection.Nat Med. 2022;28(2):410-422. doi:10.1038/s41591-021-01630-0Li P, Shi A, Lu X, et al.Incidence and impact of acute pericarditis in hospitalized patients with COVID-19.J Am Heart Assoc. 2023;12(20):e028970. doi:10.1161/JAHA.122.028970Jensen JK, Poulsen SH, Mølgaard H.Cardiac tamponade: a clinical challenge.E-Journal of Cardiology Practice. 2017;15.Centers for Disease Control and Prevention.Long COVID or post-COVID conditions.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Terzic CM, Medina-Inojosa BJ.Cardiovascular complications of coronavirus disease—2019.Phys Med Rehabil Clin N Am. 2023;34(3):551-561. doi:10.1016/j.pmr.2023.03.003Gargano JW, Wallace M, Hadler SC, et al.Use of mRNA COVID-19 vaccine after reports of myocarditis among vaccine recipients: update from the Advisory Committee on Immunization Practices — United States, June 2021.MMWR Morb Mortal Wkly Rep. 2021;70(27):977-982. doi:10.15585/mmwr.mm7027e2National Heart, Lung, and Blood Institute.Pericarditis.Theetha Kariyanna P, Sabih A, Sutarjono B, et al.A systematic review of COVID-19 and pericarditis.Cureus. 2022;14(8):e27948. doi:10.7759/cureus.27948Centers for Disease Control and Prevention.Interim clinical considerations for use of COVID-19 vaccines in the United States.Block JP, Boehmer TK, Forrest CB, et al.Cardiac complications after SARS-CoV-2 infection and mRNA COVID-19 vaccination — PCORnet, United States, January 2021–January 2022.MMWR Morb Mortal Wkly Rep. 2022;71(14):517-523. doi:10.15585/mmwr.mm7114e1Macías Saint-Gerons D, Ibarz MT, Castro JL, et al.Myopericarditis associated with the Novavax COVID-19 vaccine (NVX-CoV2373): a retrospective analysis of individual case safety reports from VigiBase.Drugs Real World Outcomes. 2023;10(2):263-270. doi:10.1007/s40801-023-00355-5U.S. Food and Drug Administration.Novavax COVID-19 vaccine (NVX-CoV2373) VRBPAC briefing document.Parotto M, Gyöngyösi M, Howe K, et al.Post-acute sequelae of COVID-19: understanding and addressing the burden of multisystem manifestations.Lancet Respir Med. 2023 Aug;11(8):739-754. doi:10.1016/S2213-2600(23)00239-4Centers for Disease Control and Prevention.Clinical considerations: myocarditis and pericarditis after receipt of COVID-19 vaccines among adolescents and young adults.American Heart Association.COVID-19 vaccine benefits still outweigh risks, despite possible rare heart complications.Centers for Disease Control and Prevention.Myocarditis and pericarditis after mRNA COVID-19 vaccinationDiaz-Arocutipa C, Saucedo-Chinchay J, Imazio M.Pericarditis in patients with COVID-19: a systematic review.J Cardiovasc Med (Hagerstown). 2021;22(9):693-700. doi:10.2459/JCM.0000000000001202Patone M, Mei XW, Handunnetthi L, et al.Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection.Nat Med. 2022;28(2):410-422. doi:10.1038/s41591-021-01630-0Li P, Shi A, Lu X, et al.Incidence and impact of acute pericarditis in hospitalized patients with COVID-19.J Am Heart Assoc. 2023;12(20):e028970. doi:10.1161/JAHA.122.028970Jensen JK, Poulsen SH, Mølgaard H.Cardiac tamponade: a clinical challenge.E-Journal of Cardiology Practice. 2017;15.Centers for Disease Control and Prevention.Long COVID or post-COVID conditions.
Terzic CM, Medina-Inojosa BJ.Cardiovascular complications of coronavirus disease—2019.Phys Med Rehabil Clin N Am. 2023;34(3):551-561. doi:10.1016/j.pmr.2023.03.003
Gargano JW, Wallace M, Hadler SC, et al.Use of mRNA COVID-19 vaccine after reports of myocarditis among vaccine recipients: update from the Advisory Committee on Immunization Practices — United States, June 2021.MMWR Morb Mortal Wkly Rep. 2021;70(27):977-982. doi:10.15585/mmwr.mm7027e2
National Heart, Lung, and Blood Institute.Pericarditis.
Theetha Kariyanna P, Sabih A, Sutarjono B, et al.A systematic review of COVID-19 and pericarditis.Cureus. 2022;14(8):e27948. doi:10.7759/cureus.27948
Centers for Disease Control and Prevention.Interim clinical considerations for use of COVID-19 vaccines in the United States.
Block JP, Boehmer TK, Forrest CB, et al.Cardiac complications after SARS-CoV-2 infection and mRNA COVID-19 vaccination — PCORnet, United States, January 2021–January 2022.MMWR Morb Mortal Wkly Rep. 2022;71(14):517-523. doi:10.15585/mmwr.mm7114e1
Macías Saint-Gerons D, Ibarz MT, Castro JL, et al.Myopericarditis associated with the Novavax COVID-19 vaccine (NVX-CoV2373): a retrospective analysis of individual case safety reports from VigiBase.Drugs Real World Outcomes. 2023;10(2):263-270. doi:10.1007/s40801-023-00355-5
U.S. Food and Drug Administration.Novavax COVID-19 vaccine (NVX-CoV2373) VRBPAC briefing document.
Parotto M, Gyöngyösi M, Howe K, et al.Post-acute sequelae of COVID-19: understanding and addressing the burden of multisystem manifestations.Lancet Respir Med. 2023 Aug;11(8):739-754. doi:10.1016/S2213-2600(23)00239-4
Centers for Disease Control and Prevention.Clinical considerations: myocarditis and pericarditis after receipt of COVID-19 vaccines among adolescents and young adults.
American Heart Association.COVID-19 vaccine benefits still outweigh risks, despite possible rare heart complications.
Centers for Disease Control and Prevention.Myocarditis and pericarditis after mRNA COVID-19 vaccination
Diaz-Arocutipa C, Saucedo-Chinchay J, Imazio M.Pericarditis in patients with COVID-19: a systematic review.J Cardiovasc Med (Hagerstown). 2021;22(9):693-700. doi:10.2459/JCM.0000000000001202
Patone M, Mei XW, Handunnetthi L, et al.Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection.Nat Med. 2022;28(2):410-422. doi:10.1038/s41591-021-01630-0
Li P, Shi A, Lu X, et al.Incidence and impact of acute pericarditis in hospitalized patients with COVID-19.J Am Heart Assoc. 2023;12(20):e028970. doi:10.1161/JAHA.122.028970
Jensen JK, Poulsen SH, Mølgaard H.Cardiac tamponade: a clinical challenge.E-Journal of Cardiology Practice. 2017;15.
Centers for Disease Control and Prevention.Long COVID or post-COVID conditions.
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