sharon sanders
Editor-in-Chief & President
Research Article
Open Access
Brief Title: Myocardial Injury after COVID-19 mRNA-1273 Booster Vaccination
Natacha Buergin1*, Pedro Lopez-Ayala1*, Julia R. Hirsiger2, Philip Mueller1, Daniela Median1, Noemi Glarner1, Klara Rumora1, Timon Herrmann1, Luca Koechlin1, Philip Haaf1, Katharina Rentsch3, Manuel Battegay4, Florian Banderet5,6, Christoph T. Berger2, 7, ChristianMueller1 1Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel; 2Department of Biomedicine, Translational Immunology, University of Basel, Basel;3Department of Laboratory Medicine, University Hospital Basel, University of Basel, Basel; 4Department of Infectious diseases & Hospital Epidemiology , University Hospital Basel, University of Basel, Basel; 5Department of Internal Medicine, Medical Outpatient Unit, University Hospital Basel, Basel; 6Employee health service, University Hospital Basel, Basel Switzerland, 7University Center for Immunology, University Hospital Basel, Basel*Both have contributed equally and should be considered first authorWord count: 3321 (max. allowed 3500)Address for correspondence: Prof. Christian Mueller, Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland. Phone Number: +41 61 328 65 49. Fax Number: +41 61 265 53 53. E-mail: christian.mueller@usb.chThis article has been accepted for publication and undergone full peer review but has not beenthrough the copyediting, typesetting, pagination and proofreading process which may lead todifferences between this version and the Version of Record. Please cite this article as doi:10.1002/ejhf.2978
Abstract
Aims:To explore the incidence and potential mechanisms of oligosymptomatic myocardial injury following COVID-19 mRNA booster vaccination.
Methods and Results: Hospital employees scheduled to undergo mRNA-1273 booster vaccination were assessed for mRNA-1273 vaccination-associated myocardial injury, defined as acute dynamic increase in high-sensitivity cardiac troponin T (hs-cTnT) concentration above the sex-specific upper-limit of normal on day 3 (48-96h) after vaccination without evidence of an alternative cause. To explore possible mechanisms, antibodies against IL-1RA, the SARS-CoV2-Nucleoprotein(NP) and -Spike(S1) proteins and an array of 14 inflammatory cytokines were quantified. Among 777 participants, median age 37 years, 69.5% women, 40 participants(5.1% [95%CI, 3.7-7.0%]) had elevated hs-cTnT concentration on day 3 and mRNA-1273 vaccine-associated myocardial injury was adjudicated in 22 participants (2.8% [95%CI, 1.7-4.3%]). Twenty cases occurred in women (3.7% [95%CI, 2.3-5.7%]), two in men (0.8% [95%CI, 0.1-3.0%]). Hs-cTnT-elevations were mild and only temporary. No patient had ECG-changes, and none developed major adverse cardiac events within 30 days (0% [95%CI, 0-0.4%]). In the overall booster cohort, hs-cTnT concentrations (day 3; median 5 [IQR, 4-6] ng/L) were significantly higher compared to matched controls (n=777, median 3 [IQR, 3-5] ng/L, p<0.001). Cases had comparable systemic reactogenicity, concentrations of anti-IL-1RA, anti-NP, anti-S1, and markers quantifying systemic inflammation, but lower concentrations of IFN-λ1(IL-29) and GM-CSF versus persons without vaccine-associated myocardial injury.
Conclusion:mRNA-1273 vaccine-associated myocardial injury was more common than previously thought, being mild and transient, and more frequent in women versus men. The possible protective role of IFN-λ1(IL-29) and GM-CSF warrant further studies.
https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2978
Open Access
Brief Title: Myocardial Injury after COVID-19 mRNA-1273 Booster Vaccination
Natacha Buergin1*, Pedro Lopez-Ayala1*, Julia R. Hirsiger2, Philip Mueller1, Daniela Median1, Noemi Glarner1, Klara Rumora1, Timon Herrmann1, Luca Koechlin1, Philip Haaf1, Katharina Rentsch3, Manuel Battegay4, Florian Banderet5,6, Christoph T. Berger2, 7, ChristianMueller1 1Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Basel; 2Department of Biomedicine, Translational Immunology, University of Basel, Basel;3Department of Laboratory Medicine, University Hospital Basel, University of Basel, Basel; 4Department of Infectious diseases & Hospital Epidemiology , University Hospital Basel, University of Basel, Basel; 5Department of Internal Medicine, Medical Outpatient Unit, University Hospital Basel, Basel; 6Employee health service, University Hospital Basel, Basel Switzerland, 7University Center for Immunology, University Hospital Basel, Basel*Both have contributed equally and should be considered first authorWord count: 3321 (max. allowed 3500)Address for correspondence: Prof. Christian Mueller, Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland. Phone Number: +41 61 328 65 49. Fax Number: +41 61 265 53 53. E-mail: christian.mueller@usb.chThis article has been accepted for publication and undergone full peer review but has not beenthrough the copyediting, typesetting, pagination and proofreading process which may lead todifferences between this version and the Version of Record. Please cite this article as doi:10.1002/ejhf.2978
Abstract
Aims:To explore the incidence and potential mechanisms of oligosymptomatic myocardial injury following COVID-19 mRNA booster vaccination.
Methods and Results: Hospital employees scheduled to undergo mRNA-1273 booster vaccination were assessed for mRNA-1273 vaccination-associated myocardial injury, defined as acute dynamic increase in high-sensitivity cardiac troponin T (hs-cTnT) concentration above the sex-specific upper-limit of normal on day 3 (48-96h) after vaccination without evidence of an alternative cause. To explore possible mechanisms, antibodies against IL-1RA, the SARS-CoV2-Nucleoprotein(NP) and -Spike(S1) proteins and an array of 14 inflammatory cytokines were quantified. Among 777 participants, median age 37 years, 69.5% women, 40 participants(5.1% [95%CI, 3.7-7.0%]) had elevated hs-cTnT concentration on day 3 and mRNA-1273 vaccine-associated myocardial injury was adjudicated in 22 participants (2.8% [95%CI, 1.7-4.3%]). Twenty cases occurred in women (3.7% [95%CI, 2.3-5.7%]), two in men (0.8% [95%CI, 0.1-3.0%]). Hs-cTnT-elevations were mild and only temporary. No patient had ECG-changes, and none developed major adverse cardiac events within 30 days (0% [95%CI, 0-0.4%]). In the overall booster cohort, hs-cTnT concentrations (day 3; median 5 [IQR, 4-6] ng/L) were significantly higher compared to matched controls (n=777, median 3 [IQR, 3-5] ng/L, p<0.001). Cases had comparable systemic reactogenicity, concentrations of anti-IL-1RA, anti-NP, anti-S1, and markers quantifying systemic inflammation, but lower concentrations of IFN-λ1(IL-29) and GM-CSF versus persons without vaccine-associated myocardial injury.
Conclusion:mRNA-1273 vaccine-associated myocardial injury was more common than previously thought, being mild and transient, and more frequent in women versus men. The possible protective role of IFN-λ1(IL-29) and GM-CSF warrant further studies.
https://onlinelibrary.wiley.com/doi/abs/10.1002/ejhf.2978