Cardiogenic Shock Due to Acute Myocarditis Following AZD1222 Vaccine Administration: a Case Report

Abstract

Aim: A number of cases of SARS-CoV-2-related myocarditis have been reported since the outbreak of the Covid-19 pandemia, with autoimmune-mediated damage due to molecular mimicry proposed as the virus’ direct mechanism of injury. After commencing with a worldwide mass vaccination program, there have also been reports of myocarditis in the context of Covid-19 immunization. However, myocarditis is still not recognized as a potential side effect of the AZD1222 (ChAdOx1-S recombinant) vaccine administration by the health authorities. Methods: In this article we report a case of myocarditis and further complications after vaccination for Covid-19 using the AZD1222 vaccine. Conclusion: Even though it is hard to demonstrate the etiology of acute myocarditis, considering the cases reported around the world, the temporal association, the absence of other plausible causes, and the serological pattern described, it seems reasonable to assume that there is a genuine possibility of myocarditis being a side effect of AZD1222 vaccine administration.

incidence of myocarditis and pericarditis in post COVID-19 unvaccinated patients

“…16 To date, only a few cases of myocarditis following exposure to the AstraZeneca COVID19 vaccine have been published. 17,18 In the current large population study of subjects, who were not vaccinated against SARS-CoV-2, we observed no increase in the incidence of myocarditis or pericarditis from day 10 after positive SARS-CoV-2. Multivariable analysis did show male sex as associated with a higher risk of developing myocarditis or pericarditis, regardless of previous COVID-19 infection.…”

Concomitant myocarditis and painless thyroiditis after AstraZeneca coronavirus disease 2019 vaccination: a case report

“…They are not widely recognized as possible adverse reactions of AstraZeneca COVID-19 vaccine, though the incidence of suspected myocarditis–pericarditis following mRNA and AstraZeneca COVID-19 vaccine from the vaccine adverse event reporting system was similar (1.6–5.0 versus 2.0–3.7 per million doses, respectively) [ 6 ]. To date, only a few cases of myocarditis following exposure to the AstraZeneca COVID-19 vaccine have been published [ 7 , 8 ]. Our patient age was not common for mRNA-induced myocarditis, but the typical age of AstraZeneca COVID-19 vaccine-related myocarditis has not previously been concluded.…”

“…Vaccine-related myocarditis usually presented with mild symptoms, which resolved spontaneously with conservative treatment [ 7 , 9 ]. A severe form presented with cardiogenic shock and need for hemodynamic support had been scarcely reported [ 8 , 10 ]. Chest pain is the most common presentation; unlike other reports, our case presented with palpitation, which could be a manifestation of myocarditis, thyroiditis, or both [ 9 ].…”