COVID-19 vaccination and cardiac dysfunction

Table 4 Gross and histopathological findings of the heart after coronavirus disease 2019 mRNA vaccination

Ref.	No. of cases (age, sex)/vaccine	Gross findings	Histopathological findings
Ameratunga et al[24]	1 (57, F)/Pfizer-BioNTech	The heart was normal without pericardial effusion and intra-cardiac thrombosis. There was a large thymoma mass (710 g) in the left pleural cavity	The heart sections showed fulminant necrotizing eosinophilic myocarditis. There were multifocal aggregates of lymphoid cells, histiocytes, and abundant eosinophils with focal myocyte necrosis in the free walls of both ventricles, interventricular septum, and around the conduction system (sino-atrial and atrioventricular nodes)
Choi et al[25]	1 (22, M)/Pfizer-BioNTech	The heart weighed 470 g with multiple petechial hemorrhages on its surface. The pericardium was smooth with no fibrin deposition or exudate. The coronary arteries were patent, and the heart valves were unremarkable	The myocardial sections showed a diffuse inflammatory infiltration with neutrophils and histiocytes predominance. The inflammatory infiltrates dominant in the atria and around the sinoatrial and atrioventricular nodes with no inflammatory cells in the ventricular muscles
Schneider et al[26]	1 (65, M)/Pfizer-BioNTech	The heart showed severe coronary sclerosis, massive cardiac hypertrophy, myocardial infarction scars	The myocardial sections showed myocarditis with lymphocytic and plasmacytoid infiltration of the perivascular space and the myocardium

F: Female; M: Male.