Index Entries

Flavio A. Cadegiani
August 11, 2022
Cureus

Dr. Cadegiani holds a position at Federal University of São Paulo (Brazil) as a mentor of the MSc and PhD programs in Clinical Endocrinology. (source)

"Abstract 

... The present review aimed to evaluate whether there is a justification to hypothesize that catecholamines in a 'hypercatecholaminergic' state are the key trigger of SARS-CoV-2 mRNA vaccine-induced myocarditis and related outcomes and whether similar risks are also present following COVID-19 infection...

A thorough, structured scoping review of the literature was performed to build the hypothesis through three pillars: detection of myocarditis risk, potential alterations and abnormalities identified after SARS-CoV-2 mRNA vaccination or COVID-19 infection and consequent events, and physiological characteristics of the most affected population... 

The epidemiological, autopsy, molecular, and physiological findings unanimously and strongly suggest that a hypercatecholaminergic state is the critical trigger of the rare cases of myocarditis due to components from SARS-CoV-2, potentially increasing sudden deaths among elite male athletes...

Introduction & Background...

Surveillance of long-term effects of COVID-19 and SARS-CoV-2 vaccines 

... An increased number of reports of myocarditis in young males and sudden deaths in male athletes chronologically following SARS-CoV-2 mRNA vaccination raised concern and led to initial investigations regarding the correlation and causality between these events and this specific type of SARS-CoV-2 vaccine. The evidence indicating that cardiac risks are specific to SARS-CoV-2 mRNA vaccines rather than to COVID-19 or post-COVID is compelling, as multiple independent groups and data from different regions demonstrated not only similar findings but also similar patterns that the second SARS-CoV-2 mRNA vaccine dose presents a stronger risk of myocarditis and pericarditis than the first dose and that the young population, particularly males, are at the highest risk... 

Myocarditis and sudden death after COVID-19 mRNA vaccination

Myocarditis induced by SARS-CoV-2 mRNA vaccines is an indisputable complication observed particularly in young males as demonstrated by multiple studies in different populations. Indeed, two studies reported that COVID-19 mRNA vaccine-induced myocarditis disproportionately affected adolescents... These findings were supported by another large registry study that identified increased myocarditis risk following SARS-CoV-2 mRNA vaccination, with the highest risk detected in people aged 18-24 years, particularly after the second dose, where 8.1-fold increased risk after the BNT162b2 SARS-CoV-2 mRNA vaccine (95% CI: 6.7-9.9) and 30-fold increased risk after the mRNA-1273 SARS-CoV-2 vaccine (95% CI: 21-43) were reported...

[T]he risk of consequential heart arrhythmia was significantly higher after vaccination than after COVID-19, possibly supporting the apparent higher incidence of sudden deaths after COVID-19 vaccination than after COVID-19...

Conclusions 

 ... We may conclude that supported by biological, clinical, and epidemiological findings, enhanced catecholamine activity or a hypercatecholaminergic state provides sufficient evidence for the highly plausible catecholamine theory of SARS-CoV-2 mRNA or spike protein-mediated myocardial complications to be considered a strong hypothesis."

document
adverse events,COVID-19,heart disorders,mRNA,vaccine dynamics,vaccines