Myocarditis-induced Sudden Death after BNT162b2 mRNA COVID-19 Vaccination in Korea: Case Report Focusing on Histopathological Findings

We present autopsy findings of a 22-year-old man who developed chest pain 5 days after the first dose of the BNT162b2 mRNA vaccine and died 7 hours later. Histological examination of the heart revealed isolated atrial myocarditis, with neutrophil and histiocyte predominance. Immunohistochemical C4d staining revealed scattered single-cell necrosis of myocytes which was not accompanied by inflammatory infiltrates. Extensive contraction band necrosis was observed in the atria and ventricles. There was no evidence of microthrombosis or infection in the heart and other organs. The primary cause of death was determined to be myocarditis, causally-associated with the BNT162b2 vaccine.

Automated summary

Autopsy findings of a 22-year-old man who died 7 hours after developing chest pain 5 days post BNT162b2 mRNA vaccine showed isolated atrial myocarditis with no evidence of microthrombosis or infection in the heart and other organs. Histological examination revealed necrosis of myocytes and extensive contraction band necrosis. The primary cause of death was determined to be myocarditis causally-associated with the BNT162b2 vaccine.