Intravenous Injection of Coronavirus Disease 2019 (COVID-19) mRNA Vaccine Can Induce Acute Myopericarditis in Mouse Model

作者：Can Li, Yanxia Chen, Yan Zhao, David Christopher Lung, Zhanhong Ye, Wenchen Song, Feifei Liu, Jian‐Piao Cai, Wan‐Man Wong, Cyril Chik‐Yan Yip, Jasper Fuk‐Woo Chan, Kelvin Kai‐Wang To, Siddharth Sridhar, Ivan Fan‐Ngai Hung, Hin Chu, Kin‐Hang Kok, Dong‐Yan Jin, Jinxia Zhang, Kwok‐Yung Yuen · 发表于：Clinical Infectious Diseases · 年份：2021 · DOI：10.1093/cid/ciab707 · 被引用次数：113 · 研究领域：Pericarditis and Cardiac Tamponade、SARS-CoV-2 and COVID-19 Research、Viral Infections and Immunology Research

BACKGROUND: Post-vaccination myopericarditis is reported after immunization with coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccines. The effect of inadvertent intravenous injection of this vaccine on the heart is unknown. METHODS: We compared the clinical manifestations, histopathological changes, tissue mRNA expression, and serum levels of cytokine/chemokine and troponin in Balb/c mice at different time points after intravenous (IV) or intramuscular (IM) vaccine injection with normal saline (NS) control. RESULTS: Although significant weight loss and higher serum cytokine/chemokine levels were found in IM group at 1-2 days post-injection (dpi), only IV group developed histopathological changes of myopericarditis as evidenced by cardiomyocyte degeneration, apoptosis, and necrosis with adjacent inflammatory cell infiltration and calcific deposits on visceral pericardium, although evidence of coronary artery or other cardiac pathologies was absent. Serum troponin level was significantly higher in IV group. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike antigen expression by immunostaining was occasionally found in infiltrating immune cells of the heart or injection site, in cardiomyocytes and intracardiac vascular endothelial cells, but not skeletal myocytes. The histological changes of myopericarditis after the first IV-priming dose persisted for 2 weeks and were markedly aggravated by a second IM- or IV-booster dose. Cardiac tissue mRNA expre...