Clinical and Diagnostic Features of Post-Acute COVID-19 Vaccination Syndrome (PACVS)
Anna Katharina Mundorf,
Amelie Semmler,
Harald Heidecke,
Matthias Schott,
Falk Steffen,
Stefan Bittner,
Karl J. Lackner,
Karin Schulze-Bosse,
Marc Pawlitzki,
Sven Guenther Meuth,
Frank Klawonn,
Jana Ruhrländer,
Fritz Boege
Affiliations
Anna Katharina Mundorf
Central Institute for Clinical Chemistry and Laboratory Diagnostics, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, 40225 Düsseldorf, Germany
Amelie Semmler
Central Institute for Clinical Chemistry and Laboratory Diagnostics, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, 40225 Düsseldorf, Germany
Harald Heidecke
CellTrend GmbH, 14943 Luckenwalde, Germany
Matthias Schott
Division for Specific Endocrinology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, 40225 Düsseldorf, Germany
Falk Steffen
Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine Main Neuroscience Network (RMN2), Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany
Stefan Bittner
Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine Main Neuroscience Network (RMN2), Medical Center, Johannes Gutenberg University Mainz, 55131 Mainz, Germany
Karl J. Lackner
University Medical Center, Johannes Gutenberg University Mainz, 55122 Mainz, Germany
Karin Schulze-Bosse
Central Institute for Clinical Chemistry and Laboratory Diagnostics, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, 40225 Düsseldorf, Germany
Marc Pawlitzki
Department of Neurology, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany
Sven Guenther Meuth
Department of Neurology, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany
Frank Klawonn
Biostatistics Research Group, Helmholtz Centre for Infection Research, 38124 Braunschweig, Germany
Jana Ruhrländer
Selbsthilfegruppe Post-Vac-Syndrom Deutschland e.V., 34121 Kassel, Germany
Fritz Boege
Central Institute for Clinical Chemistry and Laboratory Diagnostics, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University, 40225 Düsseldorf, Germany
Post-acute COVID-19 vaccination syndrome (PACVS) is a chronic disease triggered by SARS-CoV-2 vaccination (estimated prevalence 0.02%). PACVS is discriminated from the normal post-vaccination state by altered receptor antibodies, most notably angiotensin II type 1 and alpha-2B adrenergic receptor antibodies. Here, we investigate the clinical phenotype using a study registry encompassing 191 PACVS-affected persons (159 females/32 males; median ages: 39/42 years). Unbiased clustering (modified Jaccard index) of reported symptoms revealed a prevalent cross-cohort symptomatology of malaise and chronic fatigue (>80% of cases). Overlapping clusters of (i) peripheral nerve dysfunction, dysesthesia, motor weakness, pain, and vasomotor dysfunction; (ii) cardiovascular impairment; and (iii) cognitive impairment, headache, and visual and acoustic dysfunctions were also frequently represented. Notable abnormalities of standard serum markers encompassing increased interleukins 6 and 8 (>80%), low free tri-iodine thyroxine (>80%), IgG subclass imbalances (>50%), impaired iron storage (>50%), and increased soluble neurofilament light chains (>30%) were not associated with specific symptoms. Based on these data, 131/191 participants fit myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and simultaneously also several other established dysautonomia syndromes. Furthermore, 31/191 participants fit none of these syndromes. In conclusion, PACVS could either be an outlier of ME/CFS or a dysautonomia syndrome sui generis.
