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

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

Research output: Contribution to journalReview articlepeer-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.

Original languageEnglish (US)
Pages (from-to)1629-1641
Number of pages13
JournalRheumatology International
Volume42
Issue number9
DOIs
StateAccepted/In press - 2022

Keywords

  • COVID-19 vaccine
  • Dermatomyositis
  • MDA5

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology

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