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一名年轻成年人在接种第一剂mRNA-1273 SARS-CoV-2疫苗后发生急性心肌心包炎

Acute Myopericarditis After First Dose of mRNA-1273 SARS-CoV-2 Vaccine in a Young Adult.

作者信息

Fadah Kahtan, Abolbashari Mehran, Ojha Chandra, Alkhateeb Haider

机构信息

Internal Medicine, Texas Tech University Health Sciences Center, El Paso Paul L. Foster School of Medicine, El Paso, USA.

Internal Medicine, Texas Tech University Health Sciences Center, Division of Cardiovascular Medicine, El Paso, USA.

出版信息

Cureus. 2022 Feb 11;14(2):e22111. doi: 10.7759/cureus.22111. eCollection 2022 Feb.

Abstract

The coronavirus disease (COVID-19 or SARS-CoV-2) pandemic has brought the global community to a halt. A return to normalcy is dependent on effective reopening strategies that encourage herd immunity through the implementation of vaccines. Cardiopulmonary inflammation has been reported in SARS-CoV-2 infection, independent of the severity, mainly amongst the juvenile population. Cardiovascular involvement following SARS-CoV-2 infection is associated with higher mortality and morbidity. Cardiovascular complications following COVID-19 vaccination have been documented as less severe, with no link between cardiovascular injury and death. This case report describes the presentation of an otherwise healthy 18-year-old male who experienced retrosternal chest pain after receiving a first dose of the mRNA-1273 vaccine. The patient had a negative polymerase chain reaction (PCR) test for COVID-19 infection. An electrocardiogram revealed diffuse ST elevation and PR segment depression, with increased inflammatory markers consistent with pericarditis. Elevation of troponin (16 ng/mL), evidence of borderline reduced ejection fraction (50-55%), and global left ventricular hypokinesis were suggestive of myopericarditis. Infectious and autoimmune studies were negative. The patient was treated mainly with non-steroidal anti-inflammatory drugs and colchicine, which resulted in a significant improvement of clinical symptoms. As the administration of emergency COVID-19 vaccines continues worldwide, it is of paramount importance to be aware of possible adverse events, including those affecting the cardiovascular system.

摘要

冠状病毒病(COVID-19或SARS-CoV-2)大流行使全球社会陷入停滞。恢复正常取决于有效的重新开放策略,即通过实施疫苗来鼓励群体免疫。据报道,SARS-CoV-2感染中存在心肺炎症,与严重程度无关,主要发生在青少年人群中。SARS-CoV-2感染后的心血管受累与较高的死亡率和发病率相关。COVID-19疫苗接种后的心血管并发症被证明不那么严重,心血管损伤与死亡之间没有关联。本病例报告描述了一名原本健康的18岁男性在接种第一剂mRNA-1273疫苗后出现胸骨后胸痛的情况。该患者的COVID-19感染聚合酶链反应(PCR)检测呈阴性。心电图显示弥漫性ST段抬高和PR段压低,炎症标志物升高,符合心包炎表现。肌钙蛋白升高(16 ng/mL)、射血分数临界降低(50-55%)以及左心室整体运动减弱提示心肌心包炎。感染性和自身免疫性检查均为阴性。该患者主要接受非甾体抗炎药和秋水仙碱治疗,临床症状有显著改善。随着全球范围内继续接种紧急COVID-19疫苗,了解可能的不良事件,包括那些影响心血管系统的不良事件至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35c2/8918282/20cc752105d8/cureus-0014-00000022111-i01.jpg

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