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1. Multidisciplinary diagnostic approach for fulminant myocarditis related to coronavirus disease 2019 messenger RNA vaccines: a case report.

Author

Fujii M, Toba T, Fukuyama Y, Tjan LH, Mori Y, and Hirata KI

Abstract

Background: Recent reports have raised serious concerns regarding acute myocarditis related to coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines. There are only a few reports of fulminant lymphocytic myocarditis that developed after vaccination. Although the diagnostic approach varied among them, no cases with multidisciplinary diagnostic approaches, including cytokine analysis, have been reported., Case Summary: A 59-year-old male with no medical history complained of chest pain a day after receiving the first dose of COVID-19 mRNA (BNT162b2) vaccination. On hospital Day 3, he developed a refractory cardiogenic shock and pulseless ventricular tachycardia, requiring mechanical circulatory support secondary to an exacerbation of myocarditis. Based on the clinical course and examination results, including histologic findings showing a diffuse lymphocytic inflammatory infiltrate with abundant T cells and macrophages in the myocardium, and cardiac magnetic resonance (CMR) findings showing a high-intensity signal on the T2-weighted image and late gadolinium enhancement, he was diagnosed with fulminant myocarditis related to COVID-19 mRNA vaccination. His haemodynamic status gradually improved without immunosuppressive or anti-inflammatory therapy, and he was discharged from hospital on Day 47. To investigate the pathogenesis, we performed cytokine analysis, which showed an increase in serum IP-10, MCP-3, and MIG concentrations, suggesting that Th1-type chemokines preferentially promote cellular immunity., Discussion: In the present case of a patient with fulminant myocarditis following COVID-19 mRNA vaccination diagnosed through histopathological and CMR findings, additional cytokine analysis revealed that elevated levels of cytokines pertaining to Th1 immune response may be involved in disease pathogenesis. A multidisciplinary diagnostic approach is crucial not only to comprehend an individual patient's condition but also to clarify the disease pathogenesis., Competing Interests: Conflict of interest: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Published
2023
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2. Cross-Neutralizing Activity Against Omicron Could Be Obtained in SARS-CoV-2 Convalescent Patients Who Received Two Doses of mRNA Vaccination.

Author

Kurahashi Y, Furukawa K, Sutandhio S, Tjan LH, Iwata S, Sano S, Tohma Y, Ohkita H, Nakamura S, Nishimura M, Arii J, Kiriu T, Yamamoto M, Nagano T, Nishimura Y, and Mori Y

Subjects
Antibodies, Neutralizing, Antibodies, Viral, BNT162 Vaccine, Humans, Neutralization Tests, RNA, Messenger, Vaccination, COVID-19 prevention & control, SARS-CoV-2
Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant omicron is now under investigation. We evaluated cross-neutralizing activity against omicron in coronavirus disease 2019 (COVID-19) convalescent patients (n = 23) who had received 2 doses of an mRNA vaccination (BNT162b2 or mRNA-1273). Intriguingly, after the second vaccination, the neutralizing antibody titers of subjects against SARS-CoV-2 variants, including omicron, all became seropositive, and significant fold-increases (21.1-52.0) were seen regardless of the disease severity. Our findings thus demonstrate that 2 doses of mRNA vaccination to SARS-CoV-2 convalescent patients can induce cross-neutralizing activity against omicron., Competing Interests: Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed., (© The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Published
2022
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3. Induction of High Neutralizing Activity Against Both Omicron BA.2 and Omicron BA.1 by Coronavirus Disease 2019 Messenger RNA Booster Vaccination.

Author

Tjan LH, Furukawa K, Kurahashi Y, Sutandhio S, Nishimura M, Arii J, and Mori Y

Subjects
Humans, Immunization, Secondary, RNA, Messenger, Vaccination, COVID-19 prevention & control
Abstract

Competing Interests: Potential conflicts of interest. All authors: No reported conflicts. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed

Published
2022
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4. Early Differences in Cytokine Production by Severity of Coronavirus Disease 2019.

Author

Tjan LH, Furukawa K, Nagano T, Kiriu T, Nishimura M, Arii J, Hino Y, Iwata S, Nishimura Y, and Mori Y

Subjects
Adolescent, Adult, Aged, Aged, 80 and over, Asymptomatic Infections, COVID-19 blood, COVID-19 diagnosis, COVID-19 virology, COVID-19 Nucleic Acid Testing, Case-Control Studies, Female, Healthy Volunteers, Humans, Interleukin-12 immunology, Interleukin-2 immunology, Male, Middle Aged, RNA, Viral isolation & purification, SARS-CoV-2 genetics, SARS-CoV-2 isolation & purification, Severity of Illness Index, Young Adult, COVID-19 immunology, Immunity, Innate, Interleukin-12 blood, Interleukin-2 blood, SARS-CoV-2 immunology
Abstract

Most patients with coronavirus disease 2019 (COVID-19) experience asymptomatic disease or mild symptoms, but some have critical symptoms requiring intensive care. It is important to determine how patients with asymptomatic or mild COVID-19 react to severe acute respiratory syndrome coronavirus 2 infection and suppress virus spread. Innate immunity is important for evasion from the first virus attack, and it may play an important role in the pathogenesis in these patients. We measured serum cytokine levels in 95 patients with COVID-19 during the infection's acute phase and report that significantly higher interleukin 12 and 2 levels were induced in patients with asymptomatic or mild disease than in those with moderate or severe disease, indicating the key roles of these cytokines in the pathogenesis of asymptomatic or mild COVID-19., (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)

Published
2021
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