Web-based survey investigating cardiovascular complications in hypermobile Ehlers-Danlos syndrome after COVID-19 infection and vaccination

• Published in: PloS one Vol. 19; no. 3; p. e0298272
• Main Authors: Guerrerio, Anthony L, Mateja, Allyson, MacCarrick, Gretchen, Fintzi, Jonathan, Brittain, Erica, Frischmeyer-Guerrerio, Pamela A, Dietz, Harry C
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 21-03-2024; Public Library of Science (PLoS)
• Subjects: Arrhythmia; Biology and Life Sciences; Cardiovascular diseases; Comorbidity; Complications and side effects; COVID-19 - complications; COVID-19 - epidemiology; COVID-19 Vaccines - adverse effects; Cross-Sectional Studies; Development and progression; Diagnosis; Ehlers-Danlos syndrome; Ehlers-Danlos Syndrome - complications; Genetic aspects; Heart beat; Heart Diseases - complications; Humans; Internet; Joint Instability - etiology; Medicine and Health Sciences; Research and Analysis Methods; Risk factors; Surveys; Surveys and Questionnaires; Vaccination; Vaccination - adverse effects; United States
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0298272

Hypermobile Ehlers-Danlos syndrome is a heritable connective tissue disorder associated with generalized joint hypermobility but also other multisystem comorbidities, many of which may be exacerbated during a viral illness or after a vaccination. We sought to determine whether individuals with hypermobile Ehlers Danlos syndrome report an increase in adverse events, including cardiovascular events, after COVID-19 illness or vaccination.
A cross-sectional web-based survey was made available from November 22, 2021, through March 15, 2022. 368 respondents primarily from the United States self-reported data including diagnosis. We used a Cox proportional hazards model with time varying indicators for COVID-19 illness or vaccination in the previous 30 days.
We found a significantly increased rate of new abnormal heart rhythms reported in the 30 days following COVID-19 illness. No additional cardiovascular events were reported after COVID-19 illness. 2.5% of respondents with COVID-19 illness were hospitalized. We did not find a statistically significant increased rate of cardiovascular events in the 30 days following any COVID-19 vaccination dose. Post COVID-19 vaccination, 87.2% of hypermobile Ehlers-Danlos syndrome respondents endorsed an expected adverse event (EAE), and 3.1% reported an emergency department visit/hospitalization, of those who received at least one vaccine dose. Events possibly reflecting exacerbation of orthostasis/dysautonomia were common.
Respondents did not report an increased rate of any cardiovascular events in the 30 days following COVID-19 vaccination; however, those with hypermobile Ehlers-Danlos syndrome experienced a high rate of expected adverse events after vaccination consistent with a high baseline prevalence of similar symptoms. No cardiovascular events other than new abnormal heart rhythms were reported at any point after a COVID-19 illness.