Myocardial Injury after COVID-19 mRNA-1273 Booster Vaccination

Myocardial Injury after COVID-19 mRNA-1273 Booster Vaccination

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Source:

https://onlinelibrary.wiley.com/doi/epdf/10.1002/ejhf.2978

Abstract

AimsTo explore the incidence and potential mechanisms of oligosymptomatic myocardial injury following COVID-19 mRNA booster vaccination.

Methods and ResultsHospital employees scheduled to undergo mRNA-1273 booster vaccination were assessed for mRNA-1273 vaccination-associated myocardial injury, defined as acute dynamic increase in high-sensitivity cardiac troponin T (hs-cTnT) concentration above the sex-specific upper-limit of normal on day 3 (48-96 h) after vaccination without evidence of an alternative cause.

To explore possible mechanisms, antibodies against IL-1RA, the SARS-CoV2-Nucleoprotein(NP) and -Spike(S1) proteins and an array of 14 inflammatory cytokines were quantified.

Among 777 participants, median age 37 years, 69.5% women, 40 participants (5.1% [95%CI, 3.7%–7.0%]) had elevated hs-cTnT concentration on day 3 and mRNA-1273 vaccine-associated myocardial injury was adjudicated in 22 participants (2.8% [95%CI, 1.7%–4.3%]).

Twenty cases occurred in women (3.7% [95%CI, 2.3%–5.7%]), two in men (0.8% [95%CI, 0.1%–3.0%]). Hs-cTnT-elevations were mild and only temporary.

No patient had ECG-changes, and none developed major adverse cardiac events within 30 days (0% [95%CI, 0%–0.4%]). In the overall booster cohort, hs-cTnT concentrations (day 3; median 5 [IQR, 4–6] ng/L) were significantly higher compared to matched controls (n = 777, median 3 [IQR, 3–5] ng/L, p < 0.001).

Cases had comparable systemic reactogenicity, concentrations of anti-IL-1RA, anti-NP, anti-S1, and markers quantifying systemic inflammation, but lower concentrations of IFN-λ1(IL-29) and GM-CSF versus persons without vaccine-associated myocardial injury.ConclusionmRNA-1273 vaccine-associated myocardial injury was more common than previously thought, being mild and transient, and more frequent in women versus men. The possible protective role of IFN-λ1(IL-29) and GM-CSF warrant further studies.This article is protected by copyright. All rights reserved.


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