Anti-MDA5 dermatomyositis after COVID-19 vaccination: a case-based review.

Abstract

Anti-MDA5 (Melanoma differentiation-associated protein 5) myositis is a rare subtype of dermatomyositis (DM) characterized by distinct ulcerative, erythematous cutaneous lesions and a high risk of rapidly progressive interstitial lung disease (RP-ILD). It has been shown that SARS-CoV-2 (COVID-19) replicates rapidly in lung and skin epithelial cells, which is sensed by the cytosolic RNA-sensor MDA5. MDA5 then triggers type 1 interferon (IFN) production, and thus downstream inflammatory mediators (EMBO J 40(15):e107826, 2021); (J Virol, 2021, https://doi.org/10.1128/JVI.00862-21 ); (Cell Rep 34(2):108628, 2021); (Sci Rep 11(1):13638, 2021); (Trends Microbiol 27(1):75-85, 2019). It has also been shown that MDA5 is triggered by the mRNA COVID-19 vaccine with resultant activated dendritic cells (Nat Rev Immunol 21(4):195-197, 2021). Our literature review identified one reported case of MDA5-DM from the COVID-19 vaccine (Chest J, 2021, https://doi.org/10.1016/j.chest.2021.07.646 ). We present six additional cases of MDA5-DM that developed shortly after the administration of different kinds of COVID-19 vaccines. A review of other similar cases of myositis developing from the COVID-19 vaccine was also done. We aim to explore and discuss the evidence around recent speculations of a possible relation of MDA5-DM to COVID-19 infection and vaccine. The importance of vaccination during a worldwide pandemic should be maintained and our findings are not intended to discourage individuals from receiving the COVID-19 vaccine.

• Authors: Daniel Gonzalez, Latika Gupta, Vijaya Murthy, Emilio B Gonzalez, Katrina A Williamson, Ashima Makol, Chou Luan Tan, Farah Nadiah Sulaiman, Nor Shuhaila Shahril, Liza Mohd Isa, Eduardo Martín-Nares, Rohit Aggarwal
• Journal: Rheumatology international (Rheumatol Int) Vol. 42 Issue 9 Pg. 1629-1641 (09 2022) ISSN: 1437-160X [Electronic] Germany
• PMID: 35661906 (Publication Type: Journal Article, Review)
• Copyright: © 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Autoantibodies
• COVID-19 Vaccines
• Interferon-Induced Helicase, IFIH1

Topics

• Autoantibodies
• COVID-19 (prevention & control)
• COVID-19 Vaccines (adverse effects)
• Dermatomyositis (etiology)
• Humans
• Interferon-Induced Helicase, IFIH1
• Lung Diseases, Interstitial (etiology)
• SARS-CoV-2
• Vaccination