Journal
CLINICAL RESEARCH IN CARDIOLOGY
Volume 112, Issue 3, Pages 431-440Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00392-022-02129-5
Keywords
Autopsy; SARS; Cardiac pathology; Myocarditis; Vaccination
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This study describes autopsy findings of myocarditis in individuals who died unexpectedly after receiving anti-SARS-CoV-2 vaccination. Acute myocarditis was identified in four patients who received mRNA vaccination, with no other significant diseases or health issues detected. Histological examination revealed T-lymphocytic infiltration in the myocardium, predominantly involving the CD4 positive subset, and mild myocyte damage. Overall, the findings indicate that myocarditis can be a potentially lethal complication following mRNA-based anti-SARS-CoV-2 vaccination, and can help to diagnose unclear cases and establish timely in vivo diagnosis for monitoring and treating severe clinical cases.
Cases of myocarditis, diagnosed clinically by laboratory tests and imaging have been described in the context of mRNA-based anti-SARS-CoV-2 vaccination. Autopsy-based description of detailed histological features of vaccine-induced myocarditis is lacking. We describe the autopsy findings and common characteristics of myocarditis in untreated persons who received anti-SARS-CoV-2 vaccination. Standardized autopsies were performed on 25 persons who had died unexpectedly and within 20 days after anti-SARS-CoV-2 vaccination. In four patients who received a mRNA vaccination, we identified acute (epi-) myocarditis without detection of another significant disease or health constellation that may have caused an unexpected death. Histology showed patchy interstitial myocardial T-lymphocytic infiltration, predominantly of the CD4 positive subset, associated with mild myocyte damage. Overall, autopsy findings indicated death due to acute arrhythmogenic cardiac failure. Thus, myocarditis can be a potentially lethal complication following mRNA-based anti-SARS-CoV-2 vaccination. Our findings may aid in adequately diagnosing unclear cases after vaccination and in establishing a timely diagnosis in vivo, thus, providing the framework for adequate monitoring and early treatment of severe clinical cases. [GRAPHICS] .
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