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An autopsy case of fulminant myocarditis after severe acute respiratory syndrome coronavirus 2 vaccine inoculation.
Satomi, Hidetoshi; Katano, Harutaka; Kanno, Hiroyuki; Kobayashi, Mikiko; Ohkuma, Yukari; Hashidume, Naoto; Usui, Tatsuya; Tsukada, Shunichi; Ito, Ichiro.
  • Satomi H; Department of Pathology, Nagano Red Cross Hospital, Nagano, Japan.
  • Katano H; Department of Pathology, Shinshu University School of Medicine, Matsumoto, Japan.
  • Kanno H; Department of Pathology, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan.
  • Kobayashi M; Department of Pathology, Shinshu University School of Medicine, Matsumoto, Japan.
  • Ohkuma Y; Department of Pathology, Shinshu University School of Medicine, Matsumoto, Japan.
  • Hashidume N; Department of Cardiology, Nagano Red Cross Hospital, Nagano, Japan.
  • Usui T; Department of Cardiology, Nagano Red Cross Hospital, Nagano, Japan.
  • Tsukada S; Department of Cardiology, Nagano Red Cross Hospital, Nagano, Japan.
  • Ito I; Department of Cardiology, Joetsu General Hospital, Joetsu, Japan.
Pathol Int ; 72(10): 519-524, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-2008755
ABSTRACT
A 61-year-old woman without significant medical history developed fever 3 days after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination and went into shock the next day. She was negative for SARS-CoV-2 mRNA in real-time polymerase chain reaction (PCR). Finally, she died 10 days after vaccination. At autopsy, the heart showed moderate dilatation of both ventricles, and the myocardium showed an uneven color change and decreased elasticity. Histologically, severe myocarditis with extensive myocytolysis was observed. The myocarditis showed severe inflammatory cell infiltration with T-lymphocyte and macrophage predominance, and in addition to the inflammatory cells described above, vast nuclear dust accompanying neutrophilic infiltration was observed. In the bone marrow and lymph nodes, hemophagocytosis was observed. In postmortem examination, nucleic acids of any cardiotropic viruses including SARS-CoV-2 were not detected using multivirus real-time PCR system. We discussed the relationship between the possible immune reaction after vaccination and the myocarditis observed in this case from immunopathological viewpoints. This mRNA vaccine is the first applied nucleic acid vaccine for humans, and its mechanism of efficacy and immune acquisition remain unclear. We hope the accumulation of more detailed analyses of the similar cases to reveal the mechanism of this kind of adverse reaction.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / COVID-19 / Myocarditis Type of study: Case report / Prognostic study Topics: Vaccines Limits: Female / Humans / Middle aged Language: English Journal: Pathol Int Journal subject: Pathology Year: 2022 Document Type: Article Affiliation country: Pin.13267

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / COVID-19 / Myocarditis Type of study: Case report / Prognostic study Topics: Vaccines Limits: Female / Humans / Middle aged Language: English Journal: Pathol Int Journal subject: Pathology Year: 2022 Document Type: Article Affiliation country: Pin.13267