Mörz Michael
Institute of Pathology 'Georg Schmorl', The Municipal Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067 Dresden, Germany.
Vaccines (Basel). 2022 Oct 1;10(10):1651. doi: 10.3390/vaccines10101651.
The current report presents the case of a 76-year-old man with Parkinson's disease (PD) who died three weeks after receiving his third COVID-19 vaccination. The patient was first vaccinated in May 2021 with the ChAdOx1 nCov-19 vector vaccine, followed by two doses of the BNT162b2 mRNA vaccine in July and December 2021. The family of the deceased requested an autopsy due to ambiguous clinical signs before death. PD was confirmed by post-mortem examinations. Furthermore, signs of aspiration pneumonia and systemic arteriosclerosis were evident. However, histopathological analyses of the brain uncovered previously unsuspected findings, including acute vasculitis (predominantly lymphocytic) as well as multifocal necrotizing encephalitis of unknown etiology with pronounced inflammation including glial and lymphocytic reaction. In the heart, signs of chronic cardiomyopathy as well as mild acute lympho-histiocytic myocarditis and vasculitis were present. Although there was no history of COVID-19 for this patient, immunohistochemistry for SARS-CoV-2 antigens (spike and nucleocapsid proteins) was performed. Surprisingly, only spike protein but no nucleocapsid protein could be detected within the foci of inflammation in both the brain and the heart, particularly in the endothelial cells of small blood vessels. Since no nucleocapsid protein could be detected, the presence of spike protein must be ascribed to vaccination rather than to viral infection. The findings corroborate previous reports of encephalitis and myocarditis caused by gene-based COVID-19 vaccines.
本报告介绍了一名76岁帕金森病（PD）男性患者的病例，该患者在接种第三剂新冠疫苗三周后死亡。患者于2021年5月首次接种ChAdOx1 nCov-19载体疫苗，随后在2021年7月和12月接种了两剂BNT162b2 mRNA疫苗。由于患者死前临床症状不明确，其家属要求进行尸检。尸检确诊为帕金森病。此外，还发现了吸入性肺炎和全身性动脉硬化的迹象。然而，对大脑的组织病理学分析发现了一些此前未被怀疑的结果，包括急性血管炎（主要为淋巴细胞性）以及病因不明的多灶性坏死性脑炎，伴有明显炎症，包括胶质细胞和淋巴细胞反应。心脏方面，存在慢性心肌病以及轻度急性淋巴细胞-组织细胞性心肌炎和血管炎的迹象。尽管该患者没有新冠病毒感染史，但仍对其进行了SARS-CoV-2抗原（刺突蛋白和核衣壳蛋白）的免疫组化检测。令人惊讶的是，在大脑和心脏的炎症病灶中，特别是在小血管的内皮细胞中，仅检测到刺突蛋白，未检测到核衣壳蛋白。由于未检测到核衣壳蛋白，刺突蛋白的存在必定归因于疫苗接种而非病毒感染。这些发现证实了先前关于基因新冠疫苗引起脑炎和心肌炎的报道。
