Schwab et al.: "Autopsy-based histopathological characterization of myocarditis after anti-SARS-CoV-2-vaccination"; Standardized autopsies were performed on 25 persons who had died unexpectedly and
by Paul Alexander
within 20 days after anti-SARS-CoV-2 vaccination; autopsies indicated death due to acute arrhythmogenic cardiac failure; myocarditis can be a potentially lethal complication following mRNA vaccines
‘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.’
‘Among the 35 cases of the University of Heidelberg, autopsies revealed other causes of death (due to pre-existing illnesses) in 10 patients (Supplementary Table 1). Hence, these were excluded from further analysis. Cardiac autopsy findings consistent with (epi-)myocarditis were found in five cases of the remaining 25 bodies found unexpectedly dead at home within 20 days following SARS-CoV-2 vaccination. Main characteristics of the five cases are presented in Table 2, while further autopsy findings are shown in Supplementary Table 2.’
‘21 of the 30 deaths are attributed to a cardiovascular cause.’