Possible Association between Prenatal COVID-19 mRNA Vaccine Exposure and Dilated Cardiomyopathy: A Case Report

A. Murat Tuncer, Orhan Pekuz

Abstract: Pediatric Dilated Cardiomyopathy (DCM) is a cardiac condition characterized by systolic dysfunction, accompanied by bi-ventricular and atrial dilatation and reduced myocardial contractility (Ashworth, 2019). Pediatric DCM may develop as a primary congenital condition or result from another underlying condition that stresses the heart. Common etiologies include inborn errors of metabolism, syndromic causes, myocarditis, and familial cardiomyopathy. Inflammation, toxicities, or inherited pathogenic variants may also play a central role in the development of DCM. However, most pediatric DCM cases (66%-69%) remain idiopathic (Malinow, 2024). These idiopathic cases are largely believed to stem from underlying genetic abnormalities. After mass vaccination with messenger RNA (mRNA) vaccines against coronavirus disease 2019 (COVID-19), myocarditis in male teenagers emerged as a possible rare side effect (Caforio, 2021). The possible relationship between Covid-19 mRNA vaccination during pregnancy and dilated cardiomyopathy was discussed in the case of a 2-year-old boy who was diagnosed with dilated cardiomyopathy 2 years after birth, whose mother received the Covid-19 mRNA vaccine twice in the last trimester of pregnancy. Our knowledge on this subject will become clearer with further examination of the reported cases. This case report is published to contribute to this subject.

Keywords: mRNA COVID-19 vaccine, dilated cardiomyopathy, pregnant vaccination