All COVID shots increases Risk of Sudden Death in those with SCNA5 Gene Variant

This article presents a study showing a genetic basis for some people who suddenly died after the COVID shots.

Knowledge of this topic is of value because it can identify people who are at risk of sudden death with or without the COVID shots.

Background

Muscle contraction and nerve conduction rely on low voltages generated by ions. Electrolytes have electrical charges.

Sodium, potassium, and calcium are positive, and chloride ions have a negative charge. A cell membrane separates these ions. The electrolytes are divided unequally inside and outside the cell creating a net positive or negative charge depending on the condition.

At rest, the difference between the charge of the ions creates a membrane potential.

The image below shows a membrane potential caused by the different ions inside and outside a cell membrane.

Membrane potential Source: By Synaptidude, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=21460910

In an excitable cell like a muscle, the membrane potential at rest is called a resting potential, during which there is more negative charge inside the cell.

Once it needs to contract, the positive ions outside cross the cell membrane resulting in a net positive charge called depolarization.

Depolarization causes muscle contraction or nerve conduction.

SCN5A

Electrolytes cannot pass thru cell membranes. They have to pass thru ion gates. In the heart, the sodium channel Na_V1.5 changes the voltage quickly to produce effective depolarizations and cardiac contractions.

The gene SCN5A encodes for the sodium channel Na_V1.5. Variations of the SCN5A can cause conditions leading to cardiac arrythmias. One of them is Brugada Syndrome.

Brugada Syndrome

Brugada syndrome is a heart condition that can cause a fatal arrhythmia. Some who have it may not have symptoms. If they do, the common signs and symptoms are:

Dizziness
Passing out
Loss of consciousness
Shortness of breath at night
Palpitations
Rapid heartbeat
Seizures

That is why people with these complaints get an ECG in the emergency department. It has a typical ECG appearance.

Brugada syndrome can affect Whites, Asians, and both genders. It can sometimes run in the family.

Several medical institutions conducted the study in Thailand. It is peer-reviewed and published in Heart Rhythm in November 2022.

Method

In Thailand, all cases of unexplained death occurring within seven days of COVID-19 vaccination were sent for autopsies from April to December 2021.[1] There’s nothing like that in the US.

The study looked at all who died in Thailand within seven days of COVID vaccination from April to December 2021.

Thirteen subjects who died from natural but unexplained deaths within seven days of COVID vaccination were found. Exome sequencing was done in all.

Results

The subjects are between 23 and 72 years; 10 (77%) were men, 12 were Thai, and one was Australian.

Five out of thirteen cases (38%) who died within seven days after the COVID shots have the SCN5A variants seen in Brugada syndrome.

This percentage is much higher than the following groups with sudden unexplained deaths.

Those who died 8-30 days after COVID vaccination (10% [1 of 10])
Those who died with the SCN5A variant before the COVID pandemic (12% [3 of 25])
Database of patients and their parents with various rare diseases (12% [386 of 3231])

Source: Ittiwut et al. Genetic basis of sudden death after COVID-19 vaccination in Thailand. Heart Rhythm. 2022 Aug 5;19(11):1874–9.

Why did they die?

In their discussion, ventricular arrythmias can be triggered by fever after COVID vaccination in people with Brugada syndrome [2]. However, in their subjects, only three out of thirteen had a fever, and they did not find an association.

Another possibility is that myocarditis in the right ventricular outflow tract can cause a fatal arrhythmia and lead to death.[3]

There have been a lot of myocarditis deaths after the COVID shots. I wonder how many have Brugada syndrome?

Study Conclusion

SCN5A variants may be associated with Sudden Unexplained Deaths 7 days after COVID-19 vaccination, regardless of vaccine type, number of vaccine doses, and presence of underlying diseases or postvaccine fever.

They authors recommend,

…it seems prudent to closely monitor individuals who harbor variants in SCN5A, and possibly in other genes that predispose to cardiac arrhythmias or cardiomyopathies, for 7 days after the administration of COVID-19 vaccines, regardless of preexisting underlying diseases and the presence of vaccination-associated fever.

Comment

When I searched for how many people have SCN5A mutations, I didn’t see an actual number. However, I saw many types of arrhythmias associated with it. It is tough to say that it is rare because there is no data on how often it occurs.

Some people who died within a week of COVID shots could have had an SCN5A mutation, and the injections unmasked the condition to lead to an arrhythmia. This brings up an interesting question.

Should close family members of those who died without explanation within seven days of getting the shots, get genetic testing for SCN5A variants?

If more than one family member died, a stronger argument might be made for genetic testing.

This may also include family members of those who died of myocarditis. Knowing the presence of SCN5A may be helpful to the whole family.

For doctors, the article ” A Clinical Approach to a Family History of Sudden Death ” guides how to screen the rest of the family members if someone dies unexplained.

The National Heart, Lung, and Blood Institute Working Group published Screening for Sudden Cardiac Death in the Young for the pediatricians.

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References:

Ittiwut C, Mahasirimongkol S, Srisont S, Ittiwut R, Chockjamsai M, Durongkadech P, Sawaengdee W, Khunphon A, Larpadisorn K, Wattanapokayakit S, Wetchaphanphesat S, Arunotong S, Srimahachota S, Pittayawonganon C, Thammawijaya P, Sutdan D, Doungngern P, Khongphatthanayothin A, Kerr SJ, Shotelersuk V. Genetic basis of sudden death after COVID-19 vaccination in Thailand. Heart Rhythm. 2022 Aug 5;19(11):1874–9. doi: 10.1016/j.hrthm.2022.07.019. Epub ahead of print. PMID: 35934244; PMCID: PMC9352648.
Caturano A, Pafundi PC, Sasso FC, Dendramis G, Brugada P, Russo V. Brugada syndrome and COVID-19 vaccines. Europace. 2021 Dec 7;23(12):1871-1872. doi: 10.1093/europace/euab211. PMID: 34383900; PMCID: PMC8385984.
Blok M, Boukens BJ. Mechanisms of Arrhythmias in the Brugada Syndrome. Int J Mol Sci. 2020 Sep 25;21(19):7051. doi: 10.3390/ijms21197051. PMID: 32992720; PMCID: PMC7582368.
Li W, Yin L, Shen C, Hu K, Ge J, Sun A. SCN5A Variants: Association With Cardiac Disorders. Front Physiol. 2018 Oct 9;9:1372. Doi: 10.3389/fphys.2018.01372. PMID: 30364184; PMCID: PMC6191725.

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