The cellular and molecular cardiac tissue responses in human inflammatory cardiomyopathies after SARS-CoV-2 infection and COVID-19 vaccination

Journal article

H. Maatz, E. Lindberg, Eleonora Adami, Natalia López-Anguita, Alvaro Perdomo-Sabogal, Lucía Cocera Ortega, Giannino Patone, D. Reichart, Anna Myronova, Sabine Schmidt, A. Elsanhoury, Oliver Klein, Uwe Kühl, E. Wyler, M. Landthaler, S. Yousefian, Simon Haas, F. Kurth, Sarah A. Teichmann, Gavin Y. Oudit, H. Milting, M. Noseda, J. Seidman, Christine E Seidman, Bettina Heidecker, L. E. Sander, Birgit Sawitzki, Karin Klingel, P. Doeblin, S. Kelle, S. Van Linthout, Norbert Hubner, Carsten Tschöpe
Nature Cardiovascular Research, 2025

Semantic Scholar DOI PubMedCentral PubMed

Cite

APA Click to copy
Maatz, H., Lindberg, E., Adami, E., López-Anguita, N., Perdomo-Sabogal, A., Ortega, L. C., … Tschöpe, C. (2025). The cellular and molecular cardiac tissue responses in human inflammatory cardiomyopathies after SARS-CoV-2 infection and COVID-19 vaccination. Nature Cardiovascular Research.

Chicago/Turabian Click to copy
Maatz, H., E. Lindberg, Eleonora Adami, Natalia López-Anguita, Alvaro Perdomo-Sabogal, Lucía Cocera Ortega, Giannino Patone, et al. “The Cellular and Molecular Cardiac Tissue Responses in Human Inflammatory Cardiomyopathies after SARS-CoV-2 Infection and COVID-19 Vaccination.” Nature Cardiovascular Research (2025).

MLA Click to copy
Maatz, H., et al. “The Cellular and Molecular Cardiac Tissue Responses in Human Inflammatory Cardiomyopathies after SARS-CoV-2 Infection and COVID-19 Vaccination.” Nature Cardiovascular Research, 2025.

BibTeX Click to copy

@article{h2025a,
  title = {The cellular and molecular cardiac tissue responses in human inflammatory cardiomyopathies after SARS-CoV-2 infection and COVID-19 vaccination},
  year = {2025},
  journal = {Nature Cardiovascular Research},
  author = {Maatz, H. and Lindberg, E. and Adami, Eleonora and López-Anguita, Natalia and Perdomo-Sabogal, Alvaro and Ortega, Lucía Cocera and Patone, Giannino and Reichart, D. and Myronova, Anna and Schmidt, Sabine and Elsanhoury, A. and Klein, Oliver and Kühl, Uwe and Wyler, E. and Landthaler, M. and Yousefian, S. and Haas, Simon and Kurth, F. and Teichmann, Sarah A. and Oudit, Gavin Y. and Milting, H. and Noseda, M. and Seidman, J. and Seidman, Christine E and Heidecker, Bettina and Sander, L. E. and Sawitzki, Birgit and Klingel, Karin and Doeblin, P. and Kelle, S. and Linthout, S. Van and Hubner, Norbert and Tschöpe, Carsten}
}

Abstract

Myocarditis, characterized by inflammatory cell infiltration, can have multiple etiologies, including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or, rarely, mRNA-based coronavirus disease 2019 (COVID-19) vaccination. The underlying cellular and molecular mechanisms remain poorly understood. In this study, we performed single-nucleus RNA sequencing on left ventricular endomyocardial biopsies from patients with myocarditis unrelated to COVID-19 (Non-COVID-19), after SARS-CoV-2 infection (Post-COVID-19) and after COVID-19 vaccination (Post-Vaccination). We identified distinct cytokine expression patterns, with interferon-γ playing a key role in Post-COVID-19, and upregulated IL16 and IL18 expression serving as a hallmark of Post-Vaccination myocarditis. Although myeloid responses were similar across all groups, the Post-Vaccination group showed a higher proportion of CD4+ T cells, and the Post-COVID-19 group exhibited an expansion of cytotoxic CD8+ T and natural killer cells. Endothelial cells showed gene expression changes indicative of vascular barrier dysfunction in the Post-COVID-19 group and ongoing angiogenesis across all groups. These findings highlight shared and distinct mechanisms driving myocarditis in patients with and without a history of SARS-CoV-2 infection or vaccination.