Autopsy of 25 persons who died unexpectedly within 20 days of anti-SARS-CoV-2 vaccination identified acute, patchy interstitial T-lymphocytic myocarditis as the likely cause of death in four patients.
Observational (n=25)
No
Autopsy findings confirm that mRNA-based anti-SARS-CoV-2 vaccination can rarely induce a potentially lethal CD4-predominant T-lymphocytic myocarditis leading to acute arrhythmogenic cardiac failure.
Cases of myocarditis, diagnosed clinically by laboratory tests and imaging have been described in the context of mRNA-based anti-SARS-CoV-2 vaccination. Autopsy-based description of detailed histological features of vaccine-induced myocarditis is lacking. We describe the autopsy findings and common characteristics of myocarditis in untreated persons who received anti-SARS-CoV-2 vaccination. Standardized autopsies were performed on 25 persons who had died unexpectedly and within 20 days after anti-SARS-CoV-2 vaccination. In four patients who received a mRNA vaccination, we identified acute (epi-)myocarditis without detection of another significant disease or health constellation that may have caused an unexpected death. Histology showed patchy interstitial myocardial T-lymphocytic infiltration, predominantly of the CD4 positive subset, associated with mild myocyte damage. Overall, autopsy findings indicated death due to acute arrhythmogenic cardiac failure. Thus, myocarditis can be a potentially lethal complication following mRNA-based anti-SARS-CoV-2 vaccination. Our findings may aid in adequately diagnosing unclear cases after vaccination and in establishing a timely diagnosis in vivo, thus, providing the framework for adequate monitoring and early treatment of severe clinical cases.
Schwab et al. (Sun,) conducted a observational in Unexpected death after anti-SARS-CoV-2 vaccination (n=25). anti-SARS-CoV-2 vaccination (mRNA) was evaluated on Histopathological evidence of acute (epi-)myocarditis as the likely cause of death. Autopsy of 25 persons who died unexpectedly within 20 days of anti-SARS-CoV-2 vaccination identified acute, patchy interstitial T-lymphocytic myocarditis as the likely cause of death in four patients.
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