From SARS-CoV-2 to Myocarditis and Sudden Death via Molecular Mimicry and Immunologic Memory

This study aimed at defining the possible role of molecular mimicry and immunologic memory as mechanisms that might link the SARS-CoV-2 infection/immunization to cardiovascular diseases (CVDs).

Human proteins that, when affected, associate with CVDs were investigated for pentapeptide immune determinants that are shared with SARS-CoV-2 spike glycoprotein (gp).

Comparative sequence analyses reveal that SARS-CoV-2 spike gp and human proteins related to CVDs share a high level of peptide sharing; the shared peptides have immunological potential as they are also part of experimentally validated SARS-CoV-2 spike gp-derived epitopes, and the majority of the shared peptides are found in infectious pathogens to which the human population has been exposed in general.

Peptide sharing and cross-reactivity most likely represent, respectively, the molecular platform and the basic mechanism linking exposure to SARS-CoV-2 and CVDs, with the past history of the individual’s infections having a main role in determining and specifying the immune response as well as the pathologic autoimmune sequelae.