Evidence of SARS-CoV-2-Specific T-Cell-Mediated Myocarditis in a MIS-A Case.
| Publication Type | Case Report |
| Authors | Vannella K, Oguz C, Stein S, Pittaluga S, Dikoglu E, Kanwal A, Ramelli S, Briese T, Su L, Wu X, Ramos-Benitez M, Perez-Valencia L, Babyak A, Cha N, Chung J, Ylaya K, Madathil R, Saharia K, Scalea T, Tran Q, Herr D, Kleiner D, Hewitt S, Notarangelo L, Grazioli A, Chertow D |
| Journal | Front Immunol |
| Volume | 12 |
| Pagination | 779026 |
| Date Published | 12/09/2021 |
| ISSN | 1664-3224 |
| Keywords | COVID-19, Myocarditis, Systemic Inflammatory Response Syndrome, T-Lymphocytes |
| Abstract | A 26-year-old otherwise healthy man died of fulminant myocarditis. Nasopharyngeal specimens collected premortem tested negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Histopathological evaluation of the heart showed myocardial necrosis surrounded by cytotoxic T-cells and tissue-repair macrophages. Myocardial T-cell receptor (TCR) sequencing revealed hyper-dominant clones with highly similar sequences to TCRs that are specific for SARS-CoV-2 epitopes. SARS-CoV-2 RNA was detected in the gut, supporting a diagnosis of multisystem inflammatory syndrome in adults (MIS-A). Molecular targets of MIS-associated inflammation are not known. Our data indicate that SARS-CoV-2 antigens selected high-frequency T-cell clones that mediated fatal myocarditis. |
| DOI | 10.3389/fimmu.2021.779026 |
| PubMed ID | 34956207 |
| PubMed Central ID | PMC8695925 |