Genetic predisposition to long-COVID and long-COVID–like symptoms due to COVID-19 vaccines: a case of a 35-year-old woman

A 35-year-old woman with history of cardiovascular disease presented with shortness of breath, lightheadedness, fatigue, chest pain, and premature ventricular contractions (pericarditis) 3 weeks after her second COVID-19 vaccine. 

Some long-COVID–like symptoms subsided following treatment except for chest pain and fatigue. 3 weeks later, the patient tested positive for SARS-CoV-2. Shortly after infection, the patient presented again with chest pain when moving or breathing, joint pain, and dermatitis, symptoms that persisted for 6 months. Antinuclear antibody (ANA) Immunofluorescence assay screening was positive for autoimmune antibodies.

This is in line with our findings about higher probability of breakthrough infections among those with long-COVID-like reactions to COVID-19 vaccines and genetic origins of some adverse reactions. 

The patient has a family history of diabetes, high blood pressure, and cardiac cirrhosis. Genetic analyses exploring 100 genes for CVD and diabetes revealed mutations at 6 potential CVD/diabetes mellitus susceptibility loci—APOC1 (rs4420638), CETP (rs3764261), IL4 (rs2243250), AGT (rs5051), and AGT (rs699) for CVD and SLC30A8 (c.973C) for diabetes mellitus—suggesting moderate risk for developing CVD and/or diabetes mellitus, but no susceptibility genes for immune system disorders. 

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Check also this case of vaccine-induced-pericarditis after COVID-induced myocarditis. 


REFERENCE

Safronenka A, Capcha JM, Webster KA, Buglo E, Tamariz L, Goldberger JJ, Shehadeh LA. Autoimmune Reaction Associated With Long COVID Syndrome and Cardiovascular Disease: A Genetic Case Report. JACC: Case Reports. 2022 Nov 3.

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