Mancini Niccolò, Cortigiani Lauro, Aquaro Giovanni, Bovenzi Francesco Maria
U.O.C. Cardiologia ed Emodinamica, Ospedale San Luca, Lucca.
Fondazione Toscana Gabriele Monasterio, Pisa.
G Ital Cardiol (Rome). 2022 Apr;23(4):244-246. doi: 10.1714/3766.37531.
In the clinical research arsenal, the COVID-19 vaccines are the strongest weapons against the most important worldwide sanitary crisis of the last centuries. Even if vaccine adverse events have mild clinical relevance, several thromboembolic events occurring after adenoviral recombinant vaccine administration have been reported. Cases of myocarditis and pericarditis after administration of mRNA vaccines have also recently been described. We report the case of a patient who suffered from two rare adverse events after BNT162b2 mRNA vaccine administration (Pfizer-BioNTech): acute myocarditis and pulmonary embolism. Although the temporal consequentiality does not demonstrate a causal link, the strong analogies emerging in the latest clinical reports suggest a possible relation. Further studies are needed to understand the potential mechanisms of myocardial damage and atypical thrombosis. Despite the favorable and self-limiting clinical course of post-vaccinal myocarditis, in these cases a tight follow-up is advisable and vaccine adverse event reporting remains mandatory, especially if not described during pivotal clinical trials.
在临床研究的武器库中，新冠疫苗是对抗过去几个世纪以来全球最重要卫生危机的最强有力武器。即便疫苗不良事件的临床相关性较轻，但仍有报告称，接种腺病毒重组疫苗后出现了几起血栓栓塞事件。近期也有关于接种mRNA疫苗后发生心肌炎和心包炎病例的描述。我们报告了1例在接种BNT1（辉瑞 - 生物科技公司）62b2 mRNA疫苗后出现两种罕见不良事件的患者：急性心肌炎和肺栓塞。尽管时间上的先后顺序并未证明存在因果关系，但最新临床报告中出现的强烈相似性表明可能存在关联。需要进一步研究以了解心肌损伤和非典型血栓形成的潜在机制。尽管疫苗接种后心肌炎的临床过程良好且具有自限性，但对于这些病例，建议进行密切随访，并且报告疫苗不良事件仍然是强制性的，尤其是在关键临床试验中未描述的情况。
