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Volume 11
Issue 9
10.3390/pathogens11091001
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Article

Cardiac Safety of mRNA-Based Vaccines in Patients with Systemic Lupus Erythematosus and Lupus-like Disorders with a History of Myocarditis

by
Giuseppe A. Ramirez
1,2,*,†,
Veronica Batani
1,3,†,
Luca Moroni
1,2,
Giacomo De Luca
1,2,
Giuseppe Pizzetti
4,
Simone Sala
4,
Giovanni Peretto
4,
Corrado Campochiaro
1,2,
Emanuel Della-Torre
1,2,
Enrica P. Bozzolo
1 and
Lorenzo Dagna
1,2
1
Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
2
Faculty of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy
3
Faculty of Medicine, Università degli Studi di Verona, 37129 Verona, Italy
4
Unit of Cardiology, IRCCS Ospedale San Raffaele, 20132 Milan, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Pathogens 2022, 11(9), 1001; https://doi.org/10.3390/pathogens11091001
Submission received: 7 July 2022 / Revised: 30 August 2022 / Accepted: 31 August 2022 / Published: 1 September 2022
(This article belongs to the Special Issue Immune Response of the Host and Vaccine Development)
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Abstract

Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines may trigger immune-mediated adverse events, including myocarditis. Evidence of vaccine safety in patients with rheumatic disorders and underlying autoimmune myocarditis is scarce. To address this issue, we studied 13 patients with systemic lupus erythematosus (SLE) and allied conditions with a history of myocarditis and receiving mRNA-based vaccines. Data about general and cardiac laboratory tests, treatment, and disease status were collected during routine consultations before and after the primary vaccination course and after each vaccine dose administration, while myocarditis symptoms were closely monitored. A significant increase in troponin levels from baseline was found after 13 (6–20) days from the first (p = 0.046) and 17 (4–29) days after the second dose (p = 0.013). Troponin levels progressively decreased within 3 (1–6) months in the absence of typical symptoms or signs of myocarditis. A significant increase in the constitutional domain of the British Isles Lupus Assessment Group (BILAG) index (p = 0.046) was observed in SLE patients. However, no patient needed any treatment change. mRNA-based anti-SARS-CoV-2 vaccines can apparently be safely administered to patients with SLE and lupus-like disorders with previous myocarditis despite potential subclinical and transient rises in cardiac damage markers.
Keywords: myocarditis; severe acute respiratory syndrome coronavirus 2; vaccines; systemic lupus erythematosus; adverse event; disease flare myocarditis; severe acute respiratory syndrome coronavirus 2; vaccines; systemic lupus erythematosus; adverse event; disease flare

Share and Cite

MDPI and ACS Style

Ramirez, G.A.; Batani, V.; Moroni, L.; De Luca, G.; Pizzetti, G.; Sala, S.; Peretto, G.; Campochiaro, C.; Della-Torre, E.; Bozzolo, E.P.; et al. Cardiac Safety of mRNA-Based Vaccines in Patients with Systemic Lupus Erythematosus and Lupus-like Disorders with a History of Myocarditis. Pathogens 2022, 11, 1001. https://doi.org/10.3390/pathogens11091001

AMA Style

Ramirez GA, Batani V, Moroni L, De Luca G, Pizzetti G, Sala S, Peretto G, Campochiaro C, Della-Torre E, Bozzolo EP, et al. Cardiac Safety of mRNA-Based Vaccines in Patients with Systemic Lupus Erythematosus and Lupus-like Disorders with a History of Myocarditis. Pathogens. 2022; 11(9):1001. https://doi.org/10.3390/pathogens11091001

Chicago/Turabian Style

Ramirez, Giuseppe A., Veronica Batani, Luca Moroni, Giacomo De Luca, Giuseppe Pizzetti, Simone Sala, Giovanni Peretto, Corrado Campochiaro, Emanuel Della-Torre, Enrica P. Bozzolo, and et al. 2022. "Cardiac Safety of mRNA-Based Vaccines in Patients with Systemic Lupus Erythematosus and Lupus-like Disorders with a History of Myocarditis" Pathogens 11, no. 9: 1001. https://doi.org/10.3390/pathogens11091001

APA Style

Ramirez, G. A., Batani, V., Moroni, L., De Luca, G., Pizzetti, G., Sala, S., Peretto, G., Campochiaro, C., Della-Torre, E., Bozzolo, E. P., & Dagna, L. (2022). Cardiac Safety of mRNA-Based Vaccines in Patients with Systemic Lupus Erythematosus and Lupus-like Disorders with a History of Myocarditis. Pathogens, 11(9), 1001. https://doi.org/10.3390/pathogens11091001

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