J Korean Med Sci.  2022 Aug;37(34):e265. 10.3346/jkms.2022.37.e265.

A Case Report for Acute Myopericarditis After NVX-CoV2373 (Novavax®) COVID-19 Vaccination

Affiliations
  • 1Department of Cardiovascular Medicine, Chonnam National University Medical School/Hospital, Gwangju, Korea
  • 2Department of Pathology, Chonnam National University Medical School, Gwangju, Korea

Abstract

Post-vaccination myocarditis after administration of the NVX-CoV2373 coronavirus disease 2019 (COVID-19) vaccine has been reported in a limited population. We report the first biopsy-proven case of myopericarditis after administration of second dose of NVX-CoV2373 COVID-19 vaccine (Novavax®) in Korea. A 30-year-old man was referred to emergency department with complaints of chest pain and mild febrile sense for two days. He received the second dose vaccine 17 days ago. Acute myopericarditis by the vaccination was diagnosed by cardiac endomyocardial biopsy. He was treated with corticosteroid 1 mg/kg/day for 5 days and tapered for one week. He successfully recovered and was discharged on the 12th day of hospitalization. The present case suggests acute myopericarditis as a vaccination complication by Novavax® in Korea.

Keyword

Acute Myocarditis; COVID-19 Vaccine; Novavax

Figure

  • Fig. 1 Initial transthoracic echocardiography. Echocardiographic findings show increased LV wall thickness with mildly reduced LV systolic function and small amount of pericardial effusion.LV = left ventricular, EDD = end-diastolic dimension, ESD = end-systolic dimension, IVSd = interventricular septum at diastole, PWd = posterior wall thickness at diastole.

  • Fig. 2 Sigmoidoscopic findings. Endoscopic findings show mild erythema, normal vascular pattern and no erosion.

  • Fig. 3 Hospital course during admission. During hospitalization, serum cardiac troponin I and CRP levels restored to normal range with complete relief of chest pain.NRS = Numeral Rating Scale, HD = hospital day, CRP = C-reactive protein.

  • Fig. 4 Histopathologic findings of the heart. (A) HE stains of right ventricle show diffuse infiltration of lymphoid cells within myocardium (HE, ×100). (B) Immunohistochemical stains of right ventricle show CD4 positive cells (×100).HE = hematoxylin and eosin.


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