Heart failure secondary to myocarditis after SARS-CoV-2 reinfection: a case report

Abstract

Introduction: Cardiac involvement in COVID-19 can range from mild damage to severe myocarditis. The precise mechanism by which COVID-19 causes myocardial injury is still unknown. Myocarditis following administration of COVID-19 vaccines, especially those based on mRNA, has also been described. However, no reports of heart failure following reinfection with COVID-19 in patients immunized with an inactivated vaccine have been identified. Case description : Male, 47-year-old, of African descent, construction worker, with type II diabetes, with a history of infection by SARS-CoV-2 in December 2020 and May 2021, confirmed by RT-PCR. Received two doses of an inactivated vaccine against COVID-19. Between the two COVID-19 episodes with positive RT-PCR he had two episodes of bacterial lung infection. After the second episode of SARS-CoV-2 infection, he was diagnosed with severe heart failure as a sequelae of myocarditis. Conclusion: It is essential to do a proper follow-up after infection by SARS-CoV-2, since even with proper immunization, there is a possibility that the patient was reinfected and had severe cardiac sequelae as a consequence, and the hypothesis of an etiology associated with the use of an inactivated vaccine against COVID-19 with a potential immune enhancement mechanism following re-infection with SARS-CoV-2 cannot be rejected.

Cardiovascular complications of COVID-19 vaccines: A review of case-report and case-series studies

“…A total of 100 case reports or case series which reported cardiac complications after COVID-19 vaccination were included 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , …”

“…A study in Brazil reported a 47-year-old African-American male patient with type 2 diabetes and a previous history of COVID-19 infection. He had heart failure as a result of myocarditis after the second dose of an inactivated COVID-19 vaccine 45 . Other studies reported no myocarditis incidence in a subject receiving inactivated COVID-19 vaccine 126 , 127 .…”