Background
Severe acute respiratory syndrome coronavirus 2 vaccination reduces morbidity and mortality associated with coronavirus disease 2019 (COVID-19); unfortunately, it is associated with serious adverse events, including sudden unexplained death (SUD).
Objective
We aimed to study the genetic basis of SUD after COVID-19 vaccination in Thailand.
Methods
From April to December 2021, cases with natural but unexplained death within 7 days of COVID-19 vaccination were enrolled for whole exome sequencing.
Results
Thirteen were recruited, aged between 23 and 72 years; 10 (77%) were men, 12 were Thai; and 1 was Australian. Eight (61%) died after receiving the first dose of vaccine, and 7 (54%) died after receiving ChAdOx1 nCoV-19; however, there were no significant correlations between SUD and either the number or the type of vaccine. Fever was self-reported in 3 cases. Ten (77%) and 11 (85%) died within 24 hours and 3 days of vaccination, respectively. Whole exome sequencing analysis revealed that 5 cases harbored SCN5A variants that had previously been identified in patients with Brugada syndrome, giving an SCN5A variant frequency of 38% (5 of 13). This is a significantly higher rate than that observed in Thai SUD cases occurring 8–30 days after COVID-19 vaccination during the same period (10% [1 of 10]), in a Thai SUD cohort studied before the COVID-19 pandemic (12% [3 of 25]), and in our in-house exome database (12% [386 of 3231]).
Conclusion
These findings suggest that SCN5A variants may be associated with SUD within 7 days of COVID-19 vaccination, regardless of vaccine type, number of vaccine dose, and presence of underlying diseases or postvaccine fever.
【저자키워드】 COVID-19, vaccination, genetics, Sudden unexplained death (SUD), SCN5A, 【초록키워드】 coronavirus disease, Vaccine, coronavirus, COVID-19 pandemic, Sequencing, Genetic, variant, underlying disease, database, vaccine dose, Cohort, COVID-19 vaccination, Fever, Patient, death, morbidity and mortality, correlation, ChAdOx1, Frequency, Serious Adverse Events, Brugada syndrome, acute respiratory syndrome, Exome, first dose, Sequencing analysis, men, objective, Result, enrolled, died, recruited, receiving, significantly higher, reduce, 24 hour, 【제목키워드】 COVID-19 vaccination, death,