ABSTRACT
Myocarditis is defined as a myocardial injury concomitant with myocardial dysfunction. Several causes are associated with it, including infectious versus inflammatory and inherited cardiomyopathies. It can be acute, subacute, or chronic, and it can present as focal versus diffuse myocardial dysfunction. Viruses diseases, including the Coxsackie B3 virus, have been a well-established cause of viral myocarditis. It is a significant cause of mortality typically among young individuals due to lymphocytic or granulomatous inflammation of the myocardium. At present, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a detrimental cause of myocarditis with significant mortality and morbidity. Literature has revealed that most of the individuals affected by SARS-CoV-2 have significant other comorbidities, including cardiovascular, renal, or endocrine system-related comorbidities. It is noticed worldwide that patients with hypertension, diabetes mellitus, chronic obstructive pulmonary disease, and obesity are at a higher risk of developing severe infection. Obesity itself is related to chronic low-grade inflammation, and SARS-CoV-2 infection creates an environment of an inflammatory storm by excessive activation of cytokines, thus creating a vicious cycle of injury and organ damage. We present the case of a 33-year-old Hispanic morbidly obese male without other comorbidities diagnosed with SARS-CoV-2 pneumonia, complicated by severe systolic heart failure due to SARS-CoV-2 myocarditis.
ABSTRACT
For the first time, the mRNA technology was utilized to produce a vaccine against COVID-19 after the unprecedented pandemic equally affected every part of the world. Pfizer-BioNTech (BNT162b2) mRNA vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was granted emergency use authorization (EUA) by Food and Drug Administration (FDA) in December 2020. EUA has been widely discussed in the medical literature and the general public. The safety of the BNT162b2 vaccine has been investigated in short-term trials with data available for three months. We present a case of a 96-year-old female with a past surgical history of cholecystectomy who presented with acute onset severe abdominal pain a few days after getting the first dose of Pfizer-BioNTech COVID-19 vaccine. She was diagnosed with acute pancreatitis with a lipase level of 4036 U/L. Extensive history and investigations were unable to find any etiology. The patient was conservatively managed and discharged home without any complications. There has been some data available in medical literature showing an association between acute pancreatitis and COVID-19 infection. Trial data of Pfizer COVID-19 also shows one case of acute pancreatitis in the treatment group. There have also been individual cases of unexplained acute pancreatitis shared by medical professionals on online forums. Our main goal to write this case is to make medical literature aware of possible emerging side effects of the COVID-19 vaccine, one of such side effects being self-resolving uncomplicated acute pancreatitis.