Preprint Case Report Version 2 Preserved in Portico This version is not peer-reviewed

A Case Report: Multifocal Necrotizing Encephalitis and Myocarditis after BNT162b2 mRNA Vaccination against Covid-19

Version 1 : Received: 21 June 2022 / Approved: 22 June 2022 / Online: 22 June 2022 (07:53:57 CEST)
Version 2 : Received: 24 August 2022 / Approved: 25 August 2022 / Online: 25 August 2022 (03:54:58 CEST)

How to cite: Mörz, M. A Case Report: Multifocal Necrotizing Encephalitis and Myocarditis after BNT162b2 mRNA Vaccination against Covid-19. Preprints 2022, 2022060308. https://doi.org/10.20944/preprints202206.0308.v2 Mörz, M. A Case Report: Multifocal Necrotizing Encephalitis and Myocarditis after BNT162b2 mRNA Vaccination against Covid-19. Preprints 2022, 2022060308. https://doi.org/10.20944/preprints202206.0308.v2

Abstract

The current report represents a case of a 77-year-old man with Parkinson’s disease who died three weeks after receiving his third COVID-19 vaccination in January 2022. The patient was first vaccinated in May 2021 with the ChAdOx1 nCov- 19 vector vaccine, followed by two more doses with the BNT162b2 mRNA vaccine in July and December 2021. The family of the deceased requested an autopsy due to the ambivalent clinical features noted before death. The underlying illness (Parkinson’s disease) was confirmed by autopsy. However, no sign of a florid COVID-19 was discovered. Meanwhile, the immunohistochemical staining of the brain and heart revealed previously undiagnosed conditions. The brain, in distinctive, revealed multifocal necrotizing encephalitis with massive inflammatory lymphocyte infiltrates. In addition, the heart showed signs of serious myocarditis. Finally, immunohistochemical staining revealed that the SARS-CoV-2 spike protein was evident in the tissues investigated. Based on these immunohistochemical findings, it appears that the inflammatory changes in the patient's brain tissues are most likely the result of immunological processes. Concurrently, the absence of SARS-CoV-2 nucleocapsid-protein was evidenced, indicating that the detected spike-protein is unrelated to a SARS-CoV-2 infection. If such an infection was the cause of the spike protein, the SARS-CoV-2 nucleocapsid protein would also be detectable. As a consequence, the confirmed presence of the spike protein had to be attributed to the previous vaccination with the BNT162b2 mRNA vaccine that the deceased patient had received.

Keywords

mRNA Vaccine; autopsy

Subject

Medicine and Pharmacology, Pathology and Pathobiology

Comments (1)

Comment 1
Received: 25 August 2022
Commenter: Michael Mörz
Commenter's Conflict of Interests: Author
Comment: The methods section was updated with cell culture positiv control generation. Some figure letterings were clarified and extended. Finally misspelled words were corrected.
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