Post-COVID-19 Vaccination Myocarditis

Abstract

A cluster of young patients with myocarditis after SARS-CoV-2 RNA vaccination, started several days up to 2 weeks after the second shot, was reported in Israel, without a solid evidence for a cause and effect sequence of events, or any scientific, peer review publication. Most of the patients were young men who recovered with or without steroid therapy, but one 22 year-old woman died within 72 hours from start of the symptoms (chest pain and fatigue) with elevated troponin and CRP, ECG changes but normal echocardiogram. After injection of RNA the body manufactures the S protein and starts synthesize antibodies against it. My speculation is that the connection between S protein and the receptor ACE2, which is abundant on the myocardium, builds a stabile complex with high antigenicity. Antibodies attached to this complex which is now under attack by both – antibodies and T-cells. The result is severe inflammation and cytokine storm. Another possible explanation is the presence of a mediator between the receptor (ACE2) and S protein such as Defensin 5, and a complex of higher molecular weight and antigenicity causing a severe immunological attack.