Student or educator? Sign up with your school email and get 6 months of Pro free.
CoChat
Sign Up
Cited by 806

The DOI matches its Crossref record; 16 of the 16 references it cites were found in a registry or an index.

Myocarditis With COVID-19 mRNA Vaccines

Open access
Bozkurt, Biykem, Kamat, Ishan, Hotez, Peter J.·2021·Circulation
DOI 10.1161/circulationaha.121.056135
Open this paper in CoChat — free account

Abstract

Myocarditis has been recognized as a rare complication of coronavirus disease 2019 (COVID-19) mRNA vaccinations, especially in young adult and adolescent males. According to the US Centers for Disease Control and Prevention, myocarditis/pericarditis rates are ≈12.6 cases per million doses of second-dose mRNA vaccine among individuals 12 to 39 years of age. In reported cases, patients with myocarditis invariably presented with chest pain, usually 2 to 3 days after a second dose of mRNA vaccination, and had elevated cardiac troponin levels. ECG was abnormal with ST elevations in most, and cardiac MRI was suggestive of myocarditis in all tested patients. There was no evidence of acute COVID-19 or other viral infections. In 1 case, a cardiomyopathy gene panel was negative, but autoantibody levels against certain self-antigens and frequency of natural killer cells were increased. Although the mechanisms for development of myocarditis are not clear, molecular mimicry between the spike protein of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and self-antigens, trigger of preexisting dysregulated immune pathways in certain individuals, immune response to mRNA, and activation of immunologic pathways, and dysregulated cytokine expression have been proposed. The reasons for male predominance in myocarditis cases are unknown, but possible explanations relate to sex hormone differences in immune response and myocarditis, and also underdiagnosis of cardiac disease in women. Almost all patients had resolution of symptoms and signs and improvement in diagnostic markers and imaging with or without treatment. Despite rare cases of myocarditis, the benefit-risk assessment for COVID-19 vaccination shows a favorable balance for all age and sex groups; therefore, COVID-19 vaccination is recommended for everyone ≥12 years of age.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1161/circulationaha.121.056135

Cites

16 of 16 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 16 references

Research works printed but not linked: 52

  1. 10.1016/j.vaccine.2020.12.046 · DOI
  2. 10.1016/j.cpcardiol.2012.07.003 · DOI · Paper page
  3. 10.1016/j.vaccine.2015.07.035 · DOI · Paper page
  4. 10.1016/j.vaccine.2021.05.016 · DOI
  5. 10.1161/CIRCULATIONAHA.121.055891 · DOI · Paper page
  6. 10.1161/CIRCULATIONAHA.121.055913 · DOI · Paper page
  7. 10.1016/j.ijcha.2021.100774 · DOI · Paper page
  8. 10.1016/j.rec.2021.04.005 · DOI · Paper page
  9. 10.1111/acem.14322 · DOI
  10. 10.1016/j.cjca.2021.05.010 · DOI
  11. 10.1161/CIRCULATIONAHA.121.056038 · DOI
  12. 10.1001/jamacardio.2021.2833 · DOI · Paper page
  13. 10.1001/jamacardio.2021.2828 · DOI · Paper page
  14. 10.1161/CIRCULATIONAHA.120.046941 · DOI · Paper page
  15. 10.1111/j.1365-2362.2009.02153.x · DOI · Paper page
  16. 10.5144/0256-4947.2016.78 · DOI · Paper page
  17. 10.1016/j.hrthm.2020.06.026 · DOI · Paper page
  18. 10.1001/jamacardio.2020.3557 · DOI · Paper page
  19. 10.1001/jamacardio.2020.4916 · DOI · Paper page
  20. 10.1161/CIRCULATIONAHA.120.052573 · DOI · Paper page
  21. 10.1001/jamacardio.2021.0565 · DOI
  22. 10.1001/jamacardio.2020.7444 · DOI · Paper page
  23. 10.1001/jamacardio.2021.2065 · DOI · Paper page
  24. 10.1161/CIRCULATIONAHA.120.050166 · DOI
  25. 10.1001/jama.2021.2091 · DOI · Paper page
  26. 10.1016/j.carpath.2021.107361 · DOI
  27. 10.1002/ejhf.1828 · DOI · Paper page
  28. 10.1001/jamacardio.2020.3551 · DOI · Paper page
  29. 10.1016/j.jacc.2020.11.031 · DOI · Paper page
  30. 10.1161/CIRCULATIONAHA.120.049465 · DOI · Paper page
  31. 10.1016/j.carpath.2020.107300 · DOI · Paper page
  32. 10.1093/eurheartj/ehaa664 · DOI · Paper page
  33. 10.1016/j.autrev.2020.102524 · DOI
  34. 10.1016/s1388-9842(02)00010-7 · DOI · Paper page
  35. 10.1016/j.clim.2020.108480 · DOI · Paper page
  36. 10.1128/JVI.00671-11 · DOI · Paper page
  37. 10.32607/20758251-2019-11-4-22-32 · DOI
  38. 10.1093/infdis/jiaa518 · DOI · Paper page
  39. 10.1016/j.micinf.2020.04.005 · DOI
  40. 10.1038/s41577-020-0323-4 · DOI · Paper page
  41. 10.1128/jvi.76.22.11561-11569.2002 · DOI
  42. 10.1001/jamadermatol.2021.1214 · DOI
  43. 10.1016/j.jstrokecerebrovasdis.2021.105906 · DOI
  44. 10.1007/s11739-021-02685-0 · DOI
  45. 10.1146/annurev-med-061813-012806 · DOI · Paper page
  46. 10.1186/s13045-021-01100-7 · DOI
  47. Lyden, DC, Olszewski, J, Feran, M, Job, LP, Huber, SA. Coxsackievirus B-3-induced myocarditis. Effect of sex steroids on viremia and infectivity of cardiocytes. Am J Pathol. 1987;126:432–438.
  48. 10.1530/eje.0.1430031 · DOI · Paper page
  49. 10.1128/JVI.68.8.5126-5132.1994 · DOI · Paper page
  50. 10.1161/CIRCULATIONAHA.114.010376 · DOI · Paper page
  51. Aretz, HT, Billingham, ME, Edwards, WD, Factor, SM, Fallon, JT, Fenoglio, JJ, Jr, Olsen, EG, Schoen, FJ. Myocarditis. A histopathologic definition and classification. Am J Cardiovasc Pathol. 1987;1:3–14.
  52. 10.3928/19382359-20210519-02 · DOI

Cited by

See all 806

Metadata

Authors
Bozkurt, B., Kamat, I., & Hotez, P. J.
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2021-08-10
Volume
144
Issue
6
Pages
471-484
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/circulationaha.121.056135
OpenAlex
W3184597836
Cited by
806
References
16
FWCI
108.45
Type
journal article
Language
en
Open access
bronze

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

How to cite

Cite CoChat for the checks on this page, and the paper for its own findings.

This page
CoChat. (2026). Citation check: Myocarditis With COVID-19 mRNA Vaccines. https://app.cochat.ai/papers/10.1161/circulationaha.121.056135
The paper
Bozkurt, B., Kamat, I., & Hotez, P. J. (2021). Myocarditis With COVID-19 mRNA Vaccines. Circulation. https://doi.org/10.1161/circulationaha.121.056135

Data sources

Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.