Cardiovascular Complications of SARS-CoV-2 Vaccines: An Overview

• Published in: Cardiology and Therapy Vol. 11; no. 1; pp. 13 - 21
• Main Authors: Shiravi, Amir Abbas, Ardekani, Ali, Sheikhbahaei, Erfan, Heshmat-Ghahdarijani, Kiyan
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01.03.2022; Springer
• Subjects: Cardiology; Cardiovascular diseases; Internal Medicine; Medicine; Medicine & Public Health; Prevention; Review; Risk factors; Iran; COVID-19; SARS-CoV-2, COVID-19 vaccines; Thromboembolism; Cardiovascular
• ISSN: 2193-8261; 2193-6544
• DOI: 10.1007/s40119-021-00248-0

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the deadly disease known as coronavirus disease 2019 (COVID-19) that has reached pandemic proportions. Currently, there is no definitive treatment for COVID-19, although many vaccines have been developed. The World Health Organization has approved the safety and efficacy of the AstraZeneca/Oxford, Johnson and Johnson/Janssen (JnJ), Moderna, Pfizer/BioNTech, Sinopharm, and Sinovac vaccines so far. The approved formulations of AstraZeneca, JnJ, and Gam-COVID-vac (Sputnik V) contain DNA delivered within non-replicating recombinant adenovirus vector-based systems, while the Pfizer and Moderna vaccines utilize mRNA technology and lipid nanoparticle delivery systems. All of these vaccines encode production of the SARS-CoV-2 spike (S) protein, ultimately triggering immunity in the human body. COVID-19 causes several cardiovascular complications, such as arrhythmias, myocarditis, pericarditis, and venous thromboembolism. SARS-CoV-2 vaccines have been associated with rare, but sometimes fatal, cardiovascular side effects, which are the topics of this review. SARS-CoV-2 vaccines in general may cause thromboembolic events, such as cerebral vein thrombosis, and mRNA-based vaccines in particular may cause myocarditis/pericarditis, with the latter more likely to occur in younger adults after the second vaccination dose. Nevertheless, the advantages of these vaccines for ending the pandemic and/or decreasing the mortality rate outweigh any risk for the rare cardiovascular complications.