"Abstract ...
Conclusions: This exploratory analysis suggests that the levels of autoantibodies directed against ACE2, and probably also MAS1 and STAB1, may serve as biomarkers for PACVS.
1. Introduction
... It is becoming clear that even vaccinations against SARS-CoV-2 can be followed by a subacute or chronic pathological condition, the so-called post-vaccination syndrome (PVS) or long post-COVID vaccination syndrome (LPCVS) or eventually Post Acute COVID Vaccination Syndrome (PACVS). This condition can be associated with a variety of symptoms that can affect the whole body and even the psyche: general chronic fatigue, muscle and joint pain, dyspnea, numbness of the extremities, orthostatic tachycardia, hypertension, insomnia, anxiety, dizziness, and neurological and neuropsychiatric disorders. Some of these dysautonomia symptoms are also typical of postural orthostatic tachycardia syndrome (POTS) and chronic fatigue syndrome (CFS), both of which have been suggested to have an autoimmune mechanism with the finding of various autoantibodies...
The aim of this study is to present the case histories of 17 patients who had received one or more doses of [mRNA or adenoviral vector] vaccine, had no previous history of SARS-CoV-2 infection, and developed symptoms compatible with PACVS after vaccination. Diagnostic investigations included specialized antibody analyses, which are not commonly performed for this type of pathology...
4. Discussion
... One of the darkest aspects of this type of post-vaccination reaction [PACVS], which persists over time, is the lack of knowledge about its pathogenesis, which, in turn, makes the therapeutic approach difficult. In fact, all the patients who came to our medical center had been seen by other doctors who had found no therapeutic benefit in any of the drugs they had been given (e.g., antihistamines, corticosteroids, and non-steroidal anti-inflammatory drugs)...
In our case series, the main causality criteria established by the WHO manual are respected, such as the absence of other causes not related to vaccination...
Overall, our study strongly suggests that the analysis of the autoantibody panel we used and especially the dose of anti-ACE2 may have a diagnostic and perhaps predictive utility for this type of post-vaccination pathology. This hypothesis is in agreement with what has recently been reported by other authors...
In general, the genesis of PACVS can be attributed to an excessive and, above all, distorted reaction to the inoculated product."
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