SARS CoV-2 enters host cells via its Spike protein moiety binding to the essential cardiac enzyme angiotensin-converting enzyme (ACE) 2, followed by internalization. COVID-19 mRNA vaccines are RNA sequences that are translated into Spike protein, which follows the same ACE2-binding route as the intact virion. In model systems, isolated Spike protein can produce cell damage and altered gene expression, and myocardial injury or myocarditis can occur during COVID-19 or after mRNA vaccination. We investigated 7 COVID-19 and 6 post-mRNA vaccination patients with myocardial injury and found nearly identical alterations in gene expression that would predispose to inflammation, coagulopathy, and myocardial dysfunction.
Keywords: ACE, angiotensin I–converting enzyme gene; ACE2, angiotensin-converting enzyme 2 gene; AGT, angiotensinogen gene; AGTR1, angiotensin II receptor type 1 gene; ANG II, angiotensin II; BNP, B-type natriuretic peptide; CMR, cardiac magnetic resonance; COVID-19; EM, electron microscopy; F3, coagulation factor III (tissue factor) gene; ITGA5, integrin subunit alpha 5 gene; IVS, interventricular septum; LGE, late gadolinium enhancement; LM, light microscopy; LV, left ventricular; LVEF, left ventricular ejection fraction; NDC, nonischemic dilated cardiomyopathy; NPPB, natriuretic peptide B gene; RV, right ventricular; S, SARS-CoV-2 Spike; TnI, troponin I; gene expression; mRNA vaccines; myocardial injury; myocarditis.
© 2023 The Authors.