Delayed myocarditis following vaccination

 A healthy 24-year-old man with a history of allergic rhinitis experienced tightness in his chest, difficulty breathing, and coughing up blood six months after exposure to COVID-19 (he never tested positive nor experienced any symptoms) and three months after a second dose of the Moderna vaccine. 

On arrival, his oxygen level was low, his heart rate was high, he had a fever, and his blood pressure was normal. He looked very sick and was sweating. Electrocardiography (ECG) showed sinus tachycardia with diffuse ST-segment elevation and T-wave inversion (Figure).  

There were abnormal sounds in his lungs despite normal X-rays. His heart's electrical activity showed a fast rhythm with changes in the ST-segment and T-wave. Blood tests indicated heart damage and inflammation. An ultrasound of his heart showed that its pumping ability was reduced. A biopsy of his heart muscle confirmed inflammation Tests of fluid from his lungs showed no signs of bleeding or infection.

Diagnosis was a delayed allergic reaction to the COVID-19 vaccine. After three days of taking steroids, another ultrasound of his heart showed improved pumping function and his ECG looked better. He was sent home with a plan to gradually reduce his steroid medication and was prescribed lisinopril and carvedilol. At a follow-up appointment a month later, he said his chest tightness and difficulty breathing had improved, but he sometimes felt irregular heartbeats. A portable heart monitor showed a high number of abnormal heartbeats with temporary changes in the ST-segment and T-wave, so he had a loop recorder placed for longer-term monitoring of his heart.

READ MORE


REFERENCE

Janga C, Patel T, Hennawi HA, Atam S, Shah S, Naeem I, Memon R, Haas DC. Delayed presentation of biopsy-proven eosinophilic myocarditis following COVID-19 mRNA vaccine. Glob Cardiol Sci Pract. 2023 May 11;2023(2):e202310. doi: 10.21542/gcsp.2023.10. PMID: 37351099; PMCID: PMC10282781.

Comments

Post a Comment

Popular posts from this blog

A New Onset of Ulcerative Colitis post-2nd-breakthrough-COVID-19

Image
A 21-year-old non-smoking Caucasian male with a history of acute pancreatitis but no other medical issues or family history had two doses of the BNT162b2 mRNA COVID-19 vaccine.  Four months after the second dose he had his first episode of COVID-19. Although not hypoxic, he felt pretty unwell for a week, with a severe cough, fever, generalized body ache, headache, and loss of taste. He received the third dose of the vaccine two months after recovering from COVID. Nine months after the third dose, he had the second episode of COVID-19, during which he was mildly unwell for three days, recovered, and did not require any anti-viral medication or antibiotics. One week post the second episode of COVID-19, he developed diarrhea and abdominal pain. It then progressed to bloody diarrhea. Ulcerative colitis was diagnosed based on his clinical symptoms, biopsy changes, and the exclusion of other causes.  There are ten published case reports about the newly diagnosed ulcerative colitis associate
Read more

COVID in May

Image
Concerns about a potential resurgence of COVID-19 are mounting as summer 2024 approaches.  This is driven by several indicators, including social media posts, healthcare data, and wastewater surveillance across different regions. Our study findings corroborate this trend.  While many forecasters anticipate a surge, others expect a gradual increase through the end of May, and then a decline again around early June. Reports from social media suggest emerging clusters of COVID-19 in Texas, several Canadian provinces, the UK, and on cruises in northern regions such as a Norwegian cruise to Alaska.  Data from Alberta's Respiratory virus dashboard   (total weekly laboratory-confirmed COVID-19 cases) and wastewater surveillance in Calgary indicate an uptick in COVID-19 cases starting April 2024. The most recent statistics from Alberta Health reveal a significant increase in hospitalizations due to COVID-19, with 114 individuals currently hospitalized—an increase of more than 20% over two
Read more

Chronic SARS-CoV-2 Shedding

Image
Chronic viral shedding, a condition where the virus continues to be released from an individual's body long after the initial infection, has been observed in many infectious diseases, including COVID-19.  In such cases, individuals may remain asymptomatic or experience only mild symptoms while the virus persists. It remains detectable in repeated tests over an extended period and can still infect others even in nasal swab is negative (which happens quite often ). This was evident in our study.    Recent research by Conway et al. (2024) highlights the possibility of chronic SARS-CoV-2 infection, extending over several months and potentially years. Other studies have documented prolonged asymptomatic infections and extended viral shedding in moderate to severe beyond hospital discharge. Analysis of sequencing data on UK samples taken between 2 November 2020 and 15 August 2022 lead to estimates that 0.1–0.5% of infections may become persistent with typically rebounding high viral load
Read more