Pathology Deterioration in a Pure β-zero Thalassemia Heterozygote After mRNA COVID-19 Vaccination: A Case Report and Literature Review

Abstract

Case report: An asymptomatic individual with a pure β⁰ thalassemia trait, after his first and only Pfizer modified mRNA COVID-19 injection, immediately developed cardiological, neurological, and other clinically important symptoms. The patient’s severe physical impairments resembled a presyncope (about to feint [sic]) syndrome. Multiple hematological tests prior to and after the Pfizer injection revealed that the patient sustained a medically important rise in fetal hemoglobin and concurrently a remarkable drop of his hemoglobin A2 levels, compared to prior to mRNA injection. Moreover, the alterations in his life sustaining fetal hemoglobin and hemoglobinA2 levels was accompanied by a clinically significant lowering of blood hemoglobin concentration that required blood transfusion. The patient’s antibody response to the spike protein remains very high (>10,000AU/ml) even almost three years after the Pfizer injection...

Conclusions: ... By performing an investigative literature review we conclude that an autoimmune hematological disorder contributed to the patient's severe hematological stress. 

Introduction

β-thalassemia is a hereditary disorder characterized by a genetic deficiency in the synthesis of beta-globin chains, leading to impaired hemoglobin function. Symptomatically, the condition can range from having no symptoms at all to having severe and life-threatening consequences...

Conclusion

One puzzling aspect of this case is that the patient still has an abnormally high level of SARS-CoV-2 spike protein neutralizing antibodies after so many days from his single mRNA COVID-19 injection, and, to the best of our knowledge, similarly high levels have not been recorded elsewhere in the research literature so far. We hypothesize that the mRNA injectable caused an upregulation of mTOR [mammalian target of rapamycin] which interfered with autophagy, and this prevented clearance of the spike protein... This hypothesis could explain the observed issues with muscle weakness and muscle atrophy... The change in β0-thalassemia phenotype in our patient’s case, after mRNA injection, may be an alarming concern for all β-thalassemia minor trait patients receiving this kind of genetic prophylactic against COVID-19."