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Hypersensitivity Myocarditis after COVID-19 mRNA Vaccination
Andrea Frustaci1,2, Romina Verardo2, Nicola Galea3
1Department of Clinical, Internal, Anesthesiologist and Cardiovascular Sciences, La Sapienza University, 00161 Rome, Italy.
Journal of Clinical Medicine
|March 25, 2022
Summary
Severe myocarditis can occur after COVID-19 mRNA vaccination. This study identifies eosinophilic myocarditis as a potential adverse reaction, mediated by cationic protein release, which responds well to steroid treatment.
Area of Science:
- Cardiology
- Immunology
- Vaccinology
Background:
- Myocarditis, a severe inflammation of the heart muscle, can be a rare but serious complication following COVID-19 mRNA vaccination.
- The precise mechanisms and effective treatments for vaccine-associated myocarditis remain incompletely understood.
Purpose of the Study:
- To investigate the morphomolecular characteristics and potential treatment strategies for severe myocarditis post-COVID-19 mRNA vaccination.
- To elucidate the pathway involved in vaccine-induced myocarditis.
Main Methods:
- Case series of three patients experiencing severe cardiac compromise after COVID-19 mRNA (BNT162b2) vaccination.
- Utilized comprehensive cardiac evaluations including ECG, Holter monitoring, echocardiography, cardiac magnetic resonance, and endomyocardial biopsy.
- Analyzed hematochemical data and coronary angiography findings.
Main Results:
- Histological examination revealed extensive myocardial infiltration by degranulated eosinophils and elevated serum cationic protein in all patients.
- These findings suggest a hypersensitivity reaction to a vaccine component, potentially the spike protein, acting as a hapten.
- Patients treated with prednisone showed a complete recovery of cardiac function.
Conclusions:
- Eosinophilic myocarditis is identified as a potential adverse reaction to mRNA COVID-19 vaccines.
- The condition appears to be mediated by the release of cationic proteins.
- Short-term corticosteroid therapy demonstrates efficacy in treating this condition.
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