"1. Introduction
... In this study, we report an autopsy case of a 14-year-old girl who died unexpectedly 2 days after receiving the third dose of BNT1262b2 mRNA COVID-19 vaccine.
2. Case report
Despite her history of orthostatic dysregulation, [the patient] was healthy by nature and was active in her middle school athletic team. The day after vaccination, she developed a fever of 37.9 °C, which resolved by the same evening... The following morning, her mother noticed that she was not breathing and had a pale appearance... She died 45 h after the third vaccination.
2.3 Biochemical analysis
Laboratory studies revealed elevated SARS-CoV-2 antibody (43600 U/mL, normal less than 0.80), elevated IL-6 (226 pg/mL, normal ≦4.0), slightly elevated C-reactive protein (0.910 mg/mL).
2.4 Diagnosis
A diagnosis of vaccine-related multiple-organ inflammation was made based on the absence of bacterial or viral infection, lack of a past medical history suggestive of autoimmune disease, no allergic reaction, and no drug exposure other than the vaccine. Myopericarditis is a form of multiple-organ inflammation... Although the extent of inflammation was relatively narrow, the presence of foci centered on the atria and breathlessness are the findings that raise the suspicion of heart failure several hours before death. This led to the diagnosis that the cause of death was vaccine-related myopericarditis, which led to severe arrhythmias and progressive heart failure."
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