The Evaluation of Oxidative Stress in the Young Adults with COVID-19 mRNA Vaccines Induced Acute Pericarditis- Myopericarditis

Ali Dogan Dursun; Ersin Saricam; Gulcin Turkmen Sariyildiz; Murat Doğan Iscanli; Ömer Faruk Cantekin

doi:10.2147/IJGM.S347977

The Evaluation of Oxidative Stress in the Young Adults with COVID-19 mRNA Vaccines Induced Acute Pericarditis- Myopericarditis

Int J Gen Med. 2022 Jan 6:15:161-167. doi: 10.2147/IJGM.S347977. eCollection 2022.

Authors

Ali Dogan Dursun^{1

2}, Ersin Saricam^{3

4}, Gulcin Turkmen Sariyildiz^{5

6}, Murat Doğan Iscanli^{7

8}, Ömer Faruk Cantekin⁹

Affiliations

¹ Department of Physiology, Atılım University School of Medicine, Ankara, Turkey.
² Check-Up Center, Home Care Services, Medicana International Ankara Hospital, Ankara, Turkey.
³ Department of Cardiology, Medicana International Ankara Hospital, Ankara, Turkey.
⁴ Department of Cardiology, Atılım University School of Medicine, Ankara, Turkey.
⁵ Department of General Surgery, Medicana International Ankara Hospital, Ankara, Turkey.
⁶ Operating Room Services, Vocational School of Health Services, Atılım University, Ankara, Turkey.
⁷ Department of Emergency Medicine, Medicana International Ankara Hospital, Ankara, Turkey.
⁸ Department of Emergency Medicine, Atılım University School of Medicine, Ankara, Turkey.
⁹ Faculty of Health Sciences, Department of Social Work, Gazi University, Ankara, Turkey.

Abstract

Background: During COVID-19 pandemic, several vaccines have been developed such as mRNA vaccines. However, acute pericarditis and myocarditis/myopericarditis cases have been described after mRNA vaccination. The mechanism for the development of cardiac involvement is unknown. Potential mechanism for oxidative stress associated with vaccine-induced heart involvement is unidentified. This study aimed to examine the role of oxidative stress and the heart involvement in young adults vaccinated with COVID-19 mRNA vaccines.

Methods: In this cross-sectional study, a total of 23 participants were included and 10 of these participants were asymptomatic patients (control group). Comparison of the cardiac involvement and control group was made by using troponin I, C-reactive protein (hsCRP), D-dimer levels, and oxidative stress tests including nitric oxide, and imaging techniques (ECG, echocardiography, cardiovascular magnetic resonance).

Results: The median age of acute pericarditis group (10 patients) was 22 years (Q1-Q3: 18.5-31), and the mean age was 24.4±7.5 years. The median age of myopericarditis group (3 patients) was 22 years (Q1-Q3 18.0-25.0), and the mean age was 21.6 ±3.5 years. All the myopericarditis cases were male. The patients with myopericarditis had higher troponin I level, hsCRP, and D-dimer levels (troponin I level; 1600.00 ng/mL; D-dimer; 1.20 μg/mL, hsCRP; 3.0 mg/L, respectively; p < 0.05). Serum nitric oxide levels and OSI (total oxidant status, H₂O₂/total antioxidant status) were lower in myopericarditis group than the control and acute pericarditis group (p < 0.05). This shows inflammatory and procoagulant state.

Conclusion: Vaccine-induced myopericarditis cases are associated with oxidative stress test abnormality (abnormal NO, OSI levels). However, there is no relationship between NO levels and other oxidative stress tests difference in vaccine-induced acute pericarditis. It is thought that vaccine-induced pericarditis and myopericarditis could have different pathogenesis. This could make it necessary to reassess the second dose of vaccination for vaccine-induced cardiac involvement cases.

Keywords: COVID-19 vaccine; cardiac involvement; oxidative stress.