Similarities and differences between myocarditis following COVID-19 mRNA vaccine and multiple inflammatory syndrome...

Area of Science:

• Cardiology
• Immunology
• Pediatrics

Background:

• Cardiac adverse Events Following COVID-19 Immunization (c-AEFI) and Multisystem Inflammatory Syndrome in Children (MIS-C) with cardiac involvement are observed, particularly in young adult males.
• Understanding the distinct pathophysiological mechanisms of these post-immunization and post-infectious cardiac conditions is crucial.

Purpose of the Study:

• To compare the inflammatory profiles and specific biomarkers in patients with c-AEFI versus MIS-C with cardiac involvement.
• To investigate the presence of autoantibodies targeting cardiac and endothelial cells in these conditions.

Main Methods:

• Comparative analysis of inflammatory protein profiles between c-AEFI and MIS-C patient cohorts.
• Measurement of serum DHEAS, DHEA, and cortisone levels.
• Screening for anti-heart muscle and anti-endothelial cell antibodies.

Main Results:

• MIS-C patients showed higher levels of systemic inflammation proteins compared to c-AEFI patients.
• c-AEFI patients exhibited elevated levels of proteins associated with myocardial injury.
• Higher levels of DHEAS, DHEA, and cortisone were detected in c-AEFI patients, persisting at follow-up.
• No anti-heart muscle or anti-endothelial cell antibodies were found in either group.

Conclusions:

• c-AEFI and MIS-C with cardiac involvement present with distinct inflammatory and androgen profiles.
• c-AEFI appears to be a localized cardiac condition with a unique hormonal signature.
• These findings suggest different underlying mechanisms for cardiac complications following COVID-19 immunization versus MIS-C.