COVID-19 mRNAワクチンによる心筋炎

Biykem Bozkurt¹, Ishan Kamat², Peter J Hotez³

¹Winters Center for Heart Failure Research, Cardiovascular Research Institute (B.B.), Baylor College of Medicine, DeBakey VA Medical Center, Houston, TX.

Circulation

|July 20, 2021

まとめ

筋膜炎は,特に若い男性において,COVID-19 mRNAワクチンの珍しい副作用です. ほとんどの症例は治療で治り予防接種の効果はリスクを上回ります

科学分野:

心臓病科
免疫学
ワクチン学

背景:

筋膜炎は,COVID-19 mRNAワクチン接種後のまれな合併症であり,主に青春期および若い成人の男性に観察される.
報告された症例は,胸痛のような一貫した症状を示し,心筋梗塞を示唆する異常なECGとMRIの発見を示した.

研究の目的:

COVID-19 mRNAワクチン接種後の心筋梗塞の特徴,潜在的メカニズム,および臨床的結果をレビューする.
希少な心筋炎の症例に照らして,COVID-19 ワクチン接種の利益リスクバランスを評価する.

主な方法:

COVID-19 mRNAワクチン接種後の心筋炎の報告症例の分析.
臨床表現の見直し,診断マーカー (心臓のトロポニン,心電図,心臓のMRI) と病因学的調査.
分子ミミクリや免疫機能の不調を含む,提案された病理メカニズムの検討.

主要な成果:

胸の痛みを伴う心筋炎は,第二回のワクチン接種から2~3日後に発生し,トロポニンの値が上昇し,心電図でST値が上昇し,MRIが陽性であった.
急性COVID-19やその他のウイルス感染症の証拠は見つかりませんでした.ある症例では,自己抗体と自然殺人細胞が増加しました.
大半の患者は,治療を受けても受けなくても,症状の解消と診断マーカーの改善を経験しました.

結論:

COVID-19 mRNAワクチン接種は,主に若い男性において,まれに発現する心筋炎と関連しており,一般的に好ましい結果が出ています.
潜在的なメカニズムは分子模倣と免疫系活性化であり,男性の優位性はおそらくホルモンの違いに関連している.
総合的な利益リスク評価は,12歳以上の人々のCOVID-19ワクチン接種を強く支持しています.

キーワード:

コロナウイルス COVID-19 ワクチン SARS-CoV-2について mRNAワクチン心筋炎心臓炎ワクチン接種

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