Can I drink wine if I have myocarditis related to COVID-19 vaccination or infection?

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Q: Can I drink wine if I have myocarditis related to COVID-19 vaccination or infection?—Jonathan, Hawaii

A: As COVID-19 continues to circulate, researchers are still trying to understand the full range of its effects, including long COVID and how infection can impact people’s sense of taste and smell.

Another important COVID-related health phenomenon is myocarditis, or inflammation of the heart muscle that weakens the heart’s ability to pump blood throughout the body. A small number of people have experienced myocarditis linked to vaccination against COVID-19, as well as COVID-19 infection. The risk is very low, but wine lovers who do experience COVID-related myocarditis may well wonder: Can I safely drink alcohol?

Myocarditis and COVID-19

Myocarditis is rare among the general population. It can be caused by viral and bacterial infections, Chagas disease, lupus and a range of other factors, including heavy alcohol use and exposure to certain toxins. Some people have no symptoms, though the condition can cause chest pain, irregular heartbeat and, in severe cases, heart failure.

In the early days of the COVID-19 pandemic, public health officials began noticing an increase in myocarditis cases. Some of these seemed to be triggered by recent infection with COVID-19, and those cases tended to resemble myocarditis caused by other viruses.

But some cases occurred in otherwise healthy young men, typically aged 18–29, who had recently received an mRNA COVID-19 vaccine, especially the second dose. Most people with this type of myocarditis experienced mild illness compared to people with traditional myocarditis.

An August study looked at the long-term prognosis of patients with COVID-related myocarditis. The authors found that overall, people with vaccine-related myocarditis had better outcomes than people with myocarditis attributed to other causes, including COVID-19 infection. That’s good news for otherwise healthy people suffering from the condition after getting a vaccine. But the researchers didn’t look at patients’ alcohol consumption.

Should Myocarditis Patients Drink Alcohol?

Dr. Gregory Marcus, associate chief of cardiology research at UCSF Medical Center, has studied the effects of alcohol and caffeine on the heart. He told Wine Spectator that there hasn’t been enough research to say for sure if people with vaccine-induced myocarditis can safely drink: “The short answer is we don’t really know.”

Dr. Marcus says patients experiencing acute inflammation may wish to hold off on a glass of wine until their condition improves. “When a patient is in the midst of a myocarditis episode, it is probably better to avoid anything that might exacerbate the situation.” That could include alcohol, so “completely avoiding [it] probably makes sense.”

However, he says there’s probably no reason to abstain once you’ve recovered from an episode. “Once an individual has recovered from myocarditis, there is no evidence that they will then be more prone to alcohol-related heart problems than anyone else.”

Dr. Marcus stresses that excess alcohol consumption “can harm the heart and potentially lead to a weakening of the heart, or heart failure.” Indeed, chronic, heavy drinking is a known cause of traditional myocarditis. But if you’ve recovered from a vaccine-induced myocarditis episode, drinking moderately should be safe.

As always, consult your healthcare provider about incorporating wine into a healthy lifestyle.—Kenny Martin

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