Case Report: Cytomegalovirus Reactivation and Pericarditis Following ChAdOx1 nCoV-19 Vaccination Against SARS-CoV-2

https://www.frontiersin.org/files/Articles/784145/fimmu-12-784145-HTML/image_m/fimmu-12-784145-g001.jpg

Cytomegalovirus reactivation & pericarditis following #CovidVaccination (AstraZeneca):

https://www.frontiersin.org/articles/10.3389/fimmu.2021.784145/full

A 67-year-old woman

"... clinicians should be sensitized for this complication and encouraged for appropriate diagnostic testing."

Marlene Plüß1, Kemal Mese2, Johannes T. Kowallick3,4, Andreas Schuster4,5, Désirée Tampe1 and Björn Tampe1*
1Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany
2Institute of Medical Microbiology and Virology, University Medical Center Göttingen, Göttingen, Germany
3Institute of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
4German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
5Department of Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Germany
As the coronavirus disease 2019 (COVID-19) pandemic is ongoing and new variants of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) are emerging, there is an urgent need for vaccines to protect individuals at high risk for complications and to potentially control disease outbreaks by herd immunity. Surveillance of rare safety issues related to these vaccines is progressing, since more granular data emerge about adverse events of SARS-CoV-2 vaccines during post-marketing surveillance. Varicella zoster virus (VZV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV) reactivation has already been reported in COVID-19 patients. In addition, adverse events after SARS-CoV-2 mRNA vaccination have also been in the context of varicella zoster virus (VZV) reactivation and directly associated with the mRNA vaccine. We present the first case of CMV reactivation and pericarditis in temporal association with SARS-CoV-2 vaccination, particularly adenovirus-based DNA vector vaccine ChAdOx1 nCoV-19 against SARS-CoV-2. After initiation of antiviral therapy with oral valganciclovir, CMV viremia disappeared and clinical symptoms rapidly improved. Since huge vaccination programs are ongoing worldwide, post-marketing surveillance systems must be in place to assess vaccine safety that is important for the detection of any events. In the context of the hundreds of millions of individuals to be vaccinated against SARS-CoV-2, a potential causal association with CMV reactivation may result in a considerable number of cases with potentially severe complications.

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https://www.frontiersin.org/articles/10.3389/fimmu.2021.784145/full