Myocarditis-induced Sudden Death after BNT162b2 mRNA COVID-19 Vaccination in Korea: Case Report Focusing on Histopathological
https://pdfs.semanticscholar.org/cb4e/35...76de2008c12.pdf
Sangjoon Choi , SangHan Lee , Jeong-Wook Seo , Min-ju Kim ,Yo Han Jeon , Ji Hyun Park , Jong Kyu Lee , and Nam Seok Yeo
Department of Forensic Medicine, Defense Institute of Forensic Science, Criminal Investigation Command,
Ministry of National Defense, Seoul, Korea
Department of Pathology, Incheon Sejong Hospital, Incheon, Korea

ABSTRACT
We present autopsy findings of a 22-year-old man who developed chest pain 5 days after the first dose of the BNT162b2 mRNA vaccine and died 7 hours later. Histological examination of the heart revealed isolated atrial myocarditis, with neutrophil and histiocyte predominance. Immunohistochemical C4d staining revealed scattered single-cell necrosis of myocytes which was not accompanied by inflammatory infiltrates. Extensive contraction band necrosis was observed in the atria and ventricles. There was no evidence of microthrombosis or infection in the heart and other organs. The primary cause of death was determined to be myocarditis, causally-associated with the BNT162b2 vaccine.
Keywords: Sudden Cardiac Death; Myocarditis; Coronavirus Disease 19; Vaccination; mRNA Vaccines; Adverse Event Following Immunization

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This is the first case in South Korea that the Korea Centers for Disease Control and Prevention acknowledged the causality of COVID-10 vaccination and myocarditis. This unique case provides an example of a serious adverse event following COVID-19 mRNA vaccination. It is unknown whether this case is related to the vaccine type or to a specific vaccine component. It is also unclear whether the location (atrium), type of inflammation (neutrophils and histiocytes), CBN, and single-cell necrosis without inflammation are specific characteristics of COVID-19 vaccine-associated myocarditis. Comprehensive clinical and pathological evaluation of additional cases is needed to clarify the relationship between COVID-19 vaccination and myocarditis-- excerpt, rest at link above --