Vnitr Lek 2023, 69(4):E20-E27 | DOI: 10.36290/vnl.2023.054

Complications after administration of mRNA vaccine against COVID-19 - case report and short review

Ivan Varga1, Peter Michalka2, Jana Poláková Mištinová3
1 Cardio-Integra, s. r. o., Bratislava
2 Anesteziologicko-resuscitační oddělení / mezioborová JIP, Nemocnice AGEL Nový Jičín, a. s.
3 Národný ústav srdcových a cievnych chorôb, a. s., Bratislava

The pandemic of the disease COVID-19 (COronaVIrus Disease 2019) caused by the SARS-CoV-2 coronavirus (severe acute respiratory syndrome coronavirus 2) resulted in millions of deaths and many patients have chronic consequences after overcoming the acute condition. Several vaccines have been developed in an effort to stop the spread of the virus, but they have potentially serious adverse effects. We present a case report of a patient with acute (myocarditis, exacerbation of bronchial asthma) and long-term (postural orthostatic tachycardia syndrome - POTS) complications after vaccination with the second dose of mRNA vaccine BNT162b2 (Comirnaty®). Treatment consists of regimen measures, numerous pharmacotherapy (metoprolol, ivabradine, corticosteroids, antihistamines, antiphlogistics, bronchodilators) and several nutraceuticals (maritime pine bark extract, quercetin, vitamins, magnesium, phosphatidylcholine). In the discussion, we analyze post-vaccination injury and present a short review of the current literature.

Keywords: asthma, COVID-19, myocarditis, nutraceuticals, vaccination, POTS.

Accepted: June 19, 2023; Published: June 22, 2023  Show citation

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Varga I, Michalka P, Poláková Mištinová J. Complications after administration of mRNA vaccine against COVID-19 - case report and short review. Vnitr Lek. 2023;69(4):E20-27. doi: 10.36290/vnl.2023.054.
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    References

    1. Chen C, Haupert SR, Zimmermann L, et al. Global prevalence of post­‑coronavirus disease 2019 (COVID-19) condition or long COVID: a meta­‑analysis and systematic review. J Infect, DiS. 2022;226(9):1593-1607. Go to original source...
    2. Fiolet T, Kherabi Y, MacDonald CJ, et al. Comparing COVID-19 vaccines for their characteristics, efficacy and effectiveness against SARS­‑CoV-2 and variants of concern: a narrative review. Clin Microbiol Infect. 2022;28(2):202-221. Go to original source... Go to PubMed...
    3. Shiravi AA, Ardekani A, Sheikhbahaei E, et al. Cardiovascular complications of SARS­‑CoV-2 vaccines: an overview. Cardiol Ther. 2022;11(1):13-21. Go to original source... Go to PubMed...
    4. Alhumaid S, Al Mutair A, Al Alawi Z, et al. Anaphylactic and nonanaphylactic reactions to SARS­‑CoV-2 vaccines: a systematic review and meta­‑analysis. Allergy Asthma Clin Immunol. 2021;17(1):109. Go to original source... Go to PubMed...
    5. Choi S, Lee S, Seo JW, et al. Myocarditis­‑induced sudden death after BNT162b2 mRNA COVID-19 vaccination in Korea: case report focusing on histopathological findings. J Korean Med Sci 2021;36(40):e286. Go to original source... Go to PubMed...
    6. Reddy S, Reddy S, Aror, M.A. case of postural orthostatic tachycardia syndrome secondary to the messenger RNA COVID-19 vaccine. Cureus 2021;13(5):e14837. Go to original source... Go to PubMed...
    7. Said KB, Al­‑Otaibi A, Aljaloud L on behalf of the Ha'il Com Research Unit Group. The frequency and patterns of post­‑COVID-19 vaccination syndrome reveal initially mild and potentially immunocytopenic signs in primarily young Saudi women. Vaccines (Basel). 2022;10(7):1015. Go to original source... Go to PubMed...
    8. Marik PE, Kory P on behalf of the Front Line COVID-19 Critical Care Alliance (FLCCC). Prevention & Treatment protocols for COVID-19. I­‑RECOVER: Post­‑Vaccine Treatment. Available from: https://covid19criticalcare.com/covid-19-protocols/i­‑recover­‑post­‑vaccine­‑treatment/ Cited 30. 11. 2022
    9. Sovová E, Genzor S, Sova M, et al. Covid-19 a postcovid - Jekyll a Hyde moderní medicíny. Vnitř Lék 2022;68(4):208-211. Go to original source... Go to PubMed...
    10. Pesce M, Agostoni P, Bøtker HE, et al. COVID-19-related cardiac complications from clinical evidences to basic mechanisms: opinion paper of the ESC Working group on cellular biology of the heart. Cardiovasc Res. 2021;117(10):2148-2160. Go to original source...
    11. Patterson BK, Francisco EB, Yogendra R, et al. Persistence of SARS CoV-2 S1 protein in CD16+ monocytes in Post­‑Acute Sequelae of COVID-19 (PASC) up to 15 months post­‑infection. Front Immunol. 2022;12:746021. Go to original source... Go to PubMed...
    12. Polack FP, Thomas SJ, Kitchin N, et al. C4591001 Clinical Trial Group. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. N Engl J Med. 2020;383(27):2603-2615. Go to original source... Go to PubMed...
    13. Baden LR, El Sahly HM, Essink B, et al. COVE Study Group. Efficacy and safety of the mRNA-1273 SARS­‑CoV-2 vaccine. N Engl J Med. 2021;384(5):403-416. Go to original source... Go to PubMed...
    14. Mansanguan S, Charunwatthana P, Piyaphanee W, et al. Cardiovascular manifestation of the BNT162b2 mRNA COVID-19 vaccine in adolescents. Trop Med Infect, DiS. 2022 Aug 19;7(8):196. Go to original source...
    15. Pfizer. 5. 3. 6 Cumulative analysis of post­‑authorization adverse event reports of PF-07302048 (BNT162b2) received through 28-Feb-2021. Approved on 30-Apr-2021. https://phmpt.org/wp­‑content/uploads/2022/04/reissue_5. 3. 6-postmarketing­‑experience.pdf#page=30
    16. Sun CLF, Jaffe E, Levi R. Increased emergency cardiovascular events among under-40 population in Israel during vaccine rollout and third COVID-19 wave. Sci Rep. 2022;12(1):6978. Go to original source... Go to PubMed...
    17. Pillay J, Gaudet L, Wingert A, et al. Incidence, risk factors, natural history, and hypothesised mechanisms of myocarditis and pericarditis following covid-19 vaccination: living evidence syntheses and review. BMJ 2022;378:e069445. Go to original source... Go to PubMed...
    18. Cadegiani FA. Catecholamines are the key trigger of COVID-19 mRNA vaccine­‑induced myocarditis: a compelling hypothesis supported by epidemiological, anatomopathological, molecular, and physiological findings. Cureus. 2022;14(8):e27883. Go to original source... Go to PubMed...
    19. Vojdani A, Vojdani E, Kharrazian D. Reaction of human monoclonal antibodies to SARS­‑CoV-2 proteins with tissue antigens: implications for autoimmune diseases. Front Immunol. 2021;11:617089. Go to original source... Go to PubMed...
    20. Rodríguez Y, Rojas M, Beltrán S, et al. Autoimmune and autoinflammatory conditions after COVID-19 vaccination. New case reports and updated literature review. J Autoimmun. 2022;132:102898. Go to original source... Go to PubMed...
    21. Colaneri M, De Filippo M, Licari A, et al. COVID vaccination and asthma exacerbation: might there be a link? Int J Infect, DiS. 2021;112:243-246. Go to original source...
    22. Cushion S, Arboleda V, Hasanain Y, et al. Comorbidities and symptomatology of SARS­‑CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2)-related myocarditis and SARS­‑CoV-2 vaccine­‑related myocarditis: A review. Cureus. 2022;14(4):e24084. Go to original source... Go to PubMed...
    23. Fazlollahi A, Zahmatyar M, Noori M, et al. Cardiac complications following mRNA COVID-19 vaccines: A systematic review of case reports and case series. Rev Med Virol. 2022 Jul;32(4):e2318. Go to original source... Go to PubMed...
    24. Patone M, Mei XW, Handunnetthi L, Dixon S, Zaccardi F, Shankar­‑Hari M, et al. Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS­‑CoV-2 infection. Nat Med. 2022;28(2):410-422. Go to original source... Go to PubMed...
    25. Patone M, Mei XW, Handunnetthi L, et al. Risk of myocarditis after sequential doses of COVID-19 vaccine and SARS­‑CoV-2 infection by age and sex. Circulation. 2022;146(10):743-754. Go to original source... Go to PubMed...
    26. Heidecker B, Dagan N, Balicer R, et al. Myocarditis following COVID-19 vaccine: incidence, presentation, diagnosis, pathophysiology, therapy, and outcomes put into perspective. Eur J Heart Fail 2022; 24(11): 2000-2018. Go to original source... Go to PubMed...
    27. Sanchez Tijmes F, Thavendiranathan P. Cardiac MRI assessment of nonischemic myocardial inflammation: state of the art review and update on myocarditis associated with COVID-19 vaccination. Radiol Cardiothorac Imaging. 2021;3(6):e210252. Go to original source... Go to PubMed...
    28. Schauer J, Buddhe S, Gulhane A, et al. Persistent cardiac magnetic resonance imaging findings in a cohort of adolescents with post­‑coronavirus disease 2019 mRNA vaccine myopericarditis. J Pediatr. 2022;245:233-237. Go to original source... Go to PubMed...
    29. Ståhlberg M, Reistam U, Fedorowski A, et al. Post­‑COVID-19 tachycardia syndrome: a distinct phenotype of post­‑acute COVID-19 syndrome. Am J Med. 2021;134(12):1451-1456. Go to original source...
    30. Becker RC. Autonomic dysfunction in SARS­‑COV-2 infection acute and long­‑term implications. COVID-19 editor's page series. J Thromb Thrombolysis. 2021;52(3):692-707. Go to original source... Go to PubMed...
    31. Mishra R, Banerjea AC. SARS­‑CoV-2 spike targets USP33-IRF9 axis via exosomal miR-148a to activate human microglia. Front Immunol. 2021;12:656700. Go to original source... Go to PubMed...
    32. Shoenfeld Y, Ryabkova VA, Scheibenbogen C, et al. Complex syndromes of chronic pain, fatigue and cognitive impairment linked to autoimmune dysautonomia and small fiber neuropathy. Clin Immunol. 2020;214:108384. Go to original source... Go to PubMed...
    33. Takeda T, Morita H, Saito H, et al. Recent advances in understanding the roles of blood platelets in the pathogenesis of allergic inflammation and bronchial asthma. Allergol Int. 2018;67(3):326-333. Go to original source... Go to PubMed...
    34. Theoharides TC, Cholevas C, Polyzoidis K, et al. Long­‑COVID syndrome­‑associated brain fog and chemofog: luteolin to the rescue. Biofactors. 2021;47(2):232-241. Go to original source... Go to PubMed...
    35. Larsen NW, Stiles LE, Miglis MG. Preparing for the long­‑haul: autonomic complications of COVID-19. Auton Neurosci. 2021;235:102841. Go to original source... Go to PubMed...
    36. Brugada J, Katritsis DG, Arbelo E on behalf of the Task force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). 2019 ESC guidelines for the management of patients with supraventricular tachycardia. Developed in collaboration with the Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2020;41(5):655-720. Go to original source... Go to PubMed...
    37. Giannetti A, Filice E, Caffarelli C, et al. Mast Cell Activation Disorders. Medicina. 2021;57(2):124. Go to original source... Go to PubMed...
    38. Kwan AC, Ebinger JE, Wei J, et al. Apparent risks of postural orthostatic tachycardia syndrome diagnoses after COVID-19 vaccination and SARS­‑CoV-2 infection. Nat Cardiovasc Res. 2022;1:1187-1194. Go to original source... Go to PubMed...
    39. Hermel M, Sweeney M, Abud E, et al. COVID-19 vaccination might induce postural orthostatic tachycardia syndrome: a case report. Vaccines (Basel). 2022;10(7):991. Go to original source... Go to PubMed...
    40. Park J, Kim S, Lee J, An JY. A case of transient POTS following COVID-19 vaccine. Acta Neurol Belg. 2022;122(4):1081-1083. Go to original source... Go to PubMed...
    41. Karimi Galougahi K. Autonomic dysfunction post­‑inoculation with ChAdOx1 nCoV-19 vaccine. Eur Heart J Case Rep. 2021;5(12):ytab472. Go to original source... Go to PubMed...
    42. Carroll HA, Millar E, Deans KA. Vitamin B12 and D deficiency as cofactors of COVID-19 vaccine­‑induced chronic neurological adverse reactions: Two cases and a hypothesis. 8. 3. 2022, preprint (version1) available at Research Square: Available from: https://doi.org/10.21203/rs.3.rs-1425014/v1 Go to original source...
    43. Sanada Y, Azuma J, Hirano Y, et al. Overlapping myocarditis and postural orthostatic tachycardia syndrome after COVID-19 messenger RNA vaccination: a case report. Cureus. 2022;14(11):e31006. Go to original source... Go to PubMed...
    44. Demopoulos C, Antonopoulou S, Theoharides TC. COVID-19, microthromboses, inflammation, and platelet activating factor. Biofactors. 2020 Nov;46(6):927-933. Go to original source... Go to PubMed...
    45. Schenkel LC, Singh RK, Michel V, et al. Mechanism of choline deficiency and membrane alteration in postural orthostatic tachycardia syndrome primary skin fibroblasts. FASEB J. 2015;29(5):1663-1675. Go to original source... Go to PubMed...
    46. Belcaro G, Cornelli U, Cesarone MR, et al. Preventive effects of Pycnogenol® on cardiovascular risk factors (including endothelial function) and microcirculation in subjects recovering from coronavirus disease 2019 (COVID-19). Minerva Med. 2022;113(2):300-308. Go to original source... Go to PubMed...
    47. Hansen KS, Mogensen TH, Agergaard J, et al. High­‑dose coenzyme Q10 therapy versus placebo in patients with post COVID-19 condition: A randomized, phase 2, crossover trial. Lancet Reg Health Eur. 2022 Nov 2:100539. Go to original source... Go to PubMed...
    48. Dalan R, Boehm BO. Micronutrient supplementation before COVID-19 vaccination can protect against adverse effects. Clin Nutr ESPEN. 2022;47:433-434. Go to original source... Go to PubMed...
    49. Safavi F, Gustafson L, Walitt B, et al. Neuropathic symptoms with SARS­‑CoV-2 vaccination. medRxiv [Preprint] 2022 May 17:2022. 05. 16.22274439. Go to original source... Go to PubMed...
    50. Finsterer J. Small fiber neuropathy as a complication of SARSCoV2 vaccinations. J Family Med Prim Care. 2022;11:4071-4073. Go to original source... Go to PubMed...

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