Etuk Aniekeme S, Jackson Inimfon N, Panayiotou Hercules
Internal Medicine, Thomas Hospital Infirmary Health, Fairhope, USA.
Internal Medicine, Einstein Medical Center Philadelphia, Philadelphia, USA.
Cureus. 2022 May 7;14(5):e24802. doi: 10.7759/cureus.24802. eCollection 2022 May.
Myocarditis is the inflammation of the cardiac muscle caused by a variety of factors ranging from infections to autoimmune diseases. Most cases of vaccine-induced myocarditis occur after the second dose of vaccination; however, a few cases have been reported following the first dose of vaccination with or without previous coronavirus disease 2019 (COVID-19) infection. A case of myocarditis occurring about three weeks after the first dose of the Moderna vaccine has been reported in a patient with one previous COVID-19 infection. However, there have not been any documented cases of myocarditis after the first dose of the Moderna vaccine in a patient with two prior COVID-19 infections. Our index patient had already experienced two COVID-19 infections in the past and was diagnosed with myocarditis eight hours after receiving the first dose of the Moderna vaccine. The susceptibility to developing this likely stems from the possible production of antibodies to the viral antigen from previous COVID-19 infections. Furthermore, the fact that our patient developed symptoms eight hours after receiving the vaccine suggests a possible additive effect of antibodies produced from the two previous COVID-19 infections. This case report suggests that individuals repeatedly infected with COVID-19 may be at increased risk of myocarditis following the administration of the Moderna vaccine.
心肌炎是由多种因素引起的心肌炎症，这些因素包括感染到自身免疫性疾病。大多数疫苗诱导的心肌炎病例发生在第二剂疫苗接种后；然而，也有少数病例在接种第一剂疫苗后被报告，无论之前是否感染过2019冠状病毒病（COVID-19）。有一例心肌炎病例报告，一名曾感染过一次COVID-19的患者在接种第一剂Moderna疫苗约三周后发病。然而，在有两次先前COVID-19感染的患者中，尚未有接种第一剂Moderna疫苗后发生心肌炎的记录病例。我们的索引患者过去已经经历过两次COVID-19感染，并在接种第一剂Moderna疫苗八小时后被诊断为心肌炎。发生这种情况的易感性可能源于先前COVID-19感染产生的针对病毒抗原的抗体。此外，我们的患者在接种疫苗八小时后出现症状，这表明先前两次COVID-19感染产生的抗体可能存在累加效应。本病例报告表明，反复感染COVID-19的个体在接种Moderna疫苗后发生心肌炎的风险可能会增加。
