Gill et al.: "Autopsy Histopathologic Cardiac Findings in 2 Adolescents Following the Second COVID-19 Vaccine Dose"; autopsy investigation of 2 teenage boys who died shortly following 2nd Pfizer shot

The myocardial injury seen in these postvaccine hearts is different from typical myocarditis; has an appearance most closely resembling a catecholamine-mediated stress (toxic) cardiomyopathy.

James R. Gill, MD;

 Randy Tashjian, MD; Emily Duncanson, MD

Arch Pathol Lab Med (2022) 146 (8): 925–929.

https://doi.org/10.5858/arpa.2021-0435-SA

https://meridian.allenpress.com/aplm/article/146/8/925/477788/Autopsy-Histopathologic-Cardiac-Findings-in-2

“Context.—

Myocarditis in adolescents has been diagnosed clinically following the administration of the second dose of an mRNA vaccine for coronavirus disease 2019 (COVID-19).

Objective.—

To examine the autopsy microscopic cardiac findings in adolescent deaths that occurred shortly following administration of the second Pfizer-BioNTech COVID-19 dose to determine if the myocarditis described in these instances has the typical histopathology of myocarditis.

Design.—

Clinical and autopsy investigation of 2 teenage boys who died shortly following administration of the second Pfizer-BioNTech COVID-19 dose.

Results.—

The microscopic examination revealed features resembling a catecholamine-induced injury, not typical myocarditis pathology.

Conclusions.—

The myocardial injury seen in these postvaccine hearts is different from typical myocarditis and has an appearance most closely resembling a catecholamine-mediated stress (toxic) cardiomyopathy. Understanding that these instances are different from typical myocarditis and that cytokine storm has a known feedback loop with catecholamines may help guide screening and therapy.”