Cardiac Safety after AstraZeneca COVID-19 Vaccination: A Cohort Observational Study

Background: Myocarditis, an inflammatory myocardial disorder, is commonly associated with viral infections and has been reported following various vaccinations, particularly the smallpox vaccine. Recent concerns have emerged regarding the potential cardiac implications of COVID-19 mRNA vaccines. Nevertheless, evidence regarding the cardiovascular implications of AstraZeneca COVID-19 vaccine remains scarce. Aim: This study aimed to compare left ventricular (LV) systolic function between AstraZeneca COVID-19 vaccine recipients and matched unvaccinated healthy controls. Patients and methods: Over the course from June 2021 to February 2022, this prospective observational investigation was executed at Ain Shams University Hospital, enrolling 150 patients who were randomly and evenly split into two parallel arms: A vaccinated group (n=75) who received a complete two-dose regimen of AstraZeneca COVID-19 vaccine and a control group (n=75) who did not receive any COVID-19 vaccine. Subjects presenting with either established cardiac pathology or recent COVID-19 infection were excluded. Global longitudinal strain (GLS), mitral annular systolic velocity (S′), and left ventricular ejection fraction (LVEF) were assessed via transthoracic echocardiography, speckle-tracking analysis, and tissue Doppler imaging. Results: No substantial differences were observed between the vaccinated and controls regarding LVEF (63.20 ± 4.09% vs. 62.99 ± 3.59%; p=0.735), GLS (-19 [-20 to -17] vs. -19 [-20 to -18]; p=0.365), or mitral annular S′ (9.56 ± 2.07 cm/sec vs. 9.99 ± 1.95 cm/sec; p=0.196). Conclusions: Echocardiographic assessment revealed no evidence of myocardial dysfunction in relation to AstraZeneca COVID-19 vaccination, supporting its favorable cardiac safety.