Age: 32.0
Sex: M
Vaccine: COVID19
Symptoms: Back pain, Blood creatine phosphokinase MB, C-reactive protein, Chills, Echocardiogram
Clinical narrative: This literature-non-study case was reported in a literature article and describes the occurrence of PERICARDITIS (Pericarditis) in a 32-year-old male patient who received mRNA-1273 (Spikevax) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. LITERATURE REFERENCE: Diagnosing pericarditis due to COVID-19 vaccination. 79(9): 2383. No Medical History information was reported. On an unknown date, the patient received first dose of mRNA-1273 (Spikevax) (unknown route) 1 dosage form. On an unknown date, the patient experienced PERICARDITIS (Pericarditis) (seriousness criteria hospitalization and medically significant), HYPERHIDROSIS (Diaphoresis), NECK PAIN (Neck pain), BACK PAIN (Back pain) and CHILLS (Chills). The patient was treated with COLCHICINE for Pericarditis, at an unspecified dose and frequency and IBUPROFEN for Pericarditis, at an unspecified dose and frequency. At the time of the report, PERICARDITIS (Pericarditis), HYPERHIDROSIS (Diaphoresis), NECK PAIN (Neck pain), BACK PAIN (Back pain) and CHILLS (Chills) outcome was unknown. Related. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood creatine phosphokinase MB: negative (Negative) Negative. On an unknown date, C-reactive protein: elevated (High) Elevated. On an unknown date, Echocardiogram: normal left ventricular systolic and diastolic fun Normal left ventricular systolic and diastolic function, an elevated assumed right atrial pressure, mild tricuspid regurgitation and small posterior and lateral pericardial effusion. On an unknown date, Electrocardiogram: ST elevation revealed ST elevation and concavity and PR depressions in limb and precordial leads with reciprocal ST depression and PR elevation, leading to an initial concern for STEMI. On an unknown date, Influenza virus test: negative (Negative) Negative. On an unknown date, Red blood cell sedimentation rate: normal (normal) Normal. On an unknown date, SARS-CoV-2 test: negative (Negative) COVID 19 nasal PCR testing was Negative. On an unknown date, Troponin: negative (Negative) Negative. The action taken with mRNA-1273 (Spikevax) (Unknown) was unknown. For mRNA-1273 (Spikevax) (Unknown), the reporter considered PERICARDITIS (Pericarditis), HYPERHIDROSIS (Diaphoresis), NECK PAIN (Neck pain), BACK PAIN (Back pain) and CHILLS (Chills) to be related. Patient presented for one day of pressure-like chest pain with a pleuritic component that improved when sitting up. He also experienced neck and back pain as well as chills and diaphoresis. Clinical presentation was most consistent with pericarditis, and he was discharged with colchicine and ibuprofen. While vaccination cannot be proven to be the precipitant of his pericarditis, the temporal association in a healthy male with no viral or infectious symptoms is very suspicious. There is still debate on the causal relationship between mRNA vaccines and myocarditis and pericarditis. Hypotheses of mechanisms center on molecular mimicry between the spike protein and self-antigens. To identify cases of vaccine related myopericarditis, we must have a high index of suspicion in patients who present with acute symptoms after a COVID-19 mRNA vaccine without other potential causes. No concomitant medications were reported. Company comment: This literature-non-study case concerns an adult male patient aged 32 years with no medical history reported, who experienced the expected serious(medically significant/hospitalization) AESI of Pericarditis 2 days after 1st dose of mRNA-1273 vaccine. Patient presented with pleuritic chest pain along with chills, diaphoresis, neck and back pain. On admission ECG revealed concave and elevated ST with PR depression in limb and chest leads with reciprocal changes suspecting STEMI. CKMB and Troponin I done at 3 hourly interval was negative. CRP was elevated with normal ESR. Rapid influenza and COVID-19 nasal PCR test were negative Transthoracic echo showed normal left ventricular function, an elevated assumed right atrial pressure, mild tricuspid regurgitation and small posterior and lateral pericardial effusion. No further treatment details reported. Patient was discharged with colchicine and ibuprofen. Outcome of the event is not known at the time of the report. The benefit-risk relationship of mRNA-1273 is not affected by this report. Sender's Comments: This literature-non-study case concerns an adult male patient aged 32 years with no medical history reported, who experienced the expected serious(medically significant/hospitalization) AESI of Pericarditis 2 days after 1st dose of mRNA-1273 vaccine. Patient presented with pleuritic chest pain along with chills, diaphoresis, neck and back pain. On admission ECG revealed concave and elevated ST with PR depression in limb and chest leads with reciprocal changes suspecting STEMI. CKMB and Troponin I done at 3 hourly interval was negative. CRP was elevated with normal ESR. Rapid influenza and COVID-19 nasal PCR test were negative Transthoracic echo showed normal left ventricular function, an elevated assumed right atrial pressure, mild tricuspid regurgitation and small posterior and lateral pericardial effusion. No further treatment details reported. Patient was discharged with colchicine and ibuprofen. Outcome of the event is not known at the time of the report. The benefit-risk relationship of mRNA-1273 is not affected by this report.