Diagnostics of messenger ribonucleic acid (mRNA) severe acute respiratory syndrome-corona virus‑2 (SARS-CoV‑2) vaccination-associated myocarditis—A systematic review

Abstract

Background: During the recent pandemic with the severe acute respiratory syndrome-corona virus‑2 the first messenger ribonucleic acid (mRNA) vaccines were approved. To facilitate mass vaccination, confidence of the general population in these new vaccines is mandatory, which is in turn strongly dependent on the availability of reliable data on complications. Objective: Summary of the current knowledge on mRNA vaccination-associated myocarditis as a potentially fatal side effect. Methods: Systematic literature review. Results: Diagnostic algorithm for the postmortem diagnosis of mRNA vaccination-associated myocarditis. Conclusion: Autopsy series of fatalities following mRNA SARS-CoV‑2 vaccination up to 6 weeks with subsequent sophisticated and interdisciplinary work-up are necessary to complement clinical data on vaccination-associated myocarditis, especially regarding the incidence of fatal courses.