{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:09:48Z","timestamp":1740146988531,"version":"3.37.3"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:00:00Z","timestamp":1710979200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100006492","name":"Division of Intramural Research, National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006492","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["75N91019D00024"],"award-info":[{"award-number":["75N91019D00024"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000011","name":"Howard Hughes Medical Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000011","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0298272","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T17:24:21Z","timestamp":1711041861000},"page":"e0298272","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Web-based survey investigating cardiovascular complications in hypermobile Ehlers-Danlos syndrome after COVID-19 infection and vaccination"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2458-7160","authenticated-orcid":true,"given":"Anthony L.","family":"Guerrerio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allyson","family":"Mateja","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gretchen","family":"MacCarrick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Fintzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica","family":"Brittain","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela A.","family":"Frischmeyer-Guerrerio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harry C.","family":"Dietz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,3,21]]},"reference":[{"issue":"1","key":"pone.0298272.ref001","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1002\/ajmg.c.31538","article-title":"Hypermobile Ehlers-Danlos syndrome (a.k.a. Ehlers-Danlos syndrome Type III and Ehlers-Danlos syndrome hypermobility type): Clinical description and natural history","volume":"175","author":"B Tinkle","year":"2017","journal-title":"Am J Med Genet C Semin Med Genet"},{"issue":"3","key":"pone.0298272.ref002","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1080\/09638288.2017.1390695","article-title":"Subjective health complaints and illness perception amongst adults with Joint Hypermobility Syndrome\/Ehlers-Danlos Syndrome-HypermobilityType\u2014a cross-sectional study","volume":"41","author":"L Hope","year":"2019","journal-title":"Disabil Rehabil"},{"issue":"3","key":"pone.0298272.ref003","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1002\/dvdy.220","article-title":"Hypermobile Ehlers-Danlos syndromes: Complex phenotypes, challenging diagnoses, and poorly understood causes","volume":"250","author":"C Gensemer","year":"2021","journal-title":"Dev Dyn"},{"issue":"3","key":"pone.0298272.ref004","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1038\/s41591-022-01689-3","article-title":"Long-term cardiovascular outcomes of COVID-19","volume":"28","author":"Y Xie","year":"2022","journal-title":"Nat Med"},{"key":"pone.0298272.ref005","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.ijcard.2022.01.037","article-title":"Myocarditis after RNA-based vaccines for coronavirus","volume":"353","author":"A Cordero","year":"2022","journal-title":"Int J Cardiol"},{"issue":"4","key":"pone.0298272.ref006","doi-asserted-by":"crossref","first-page":"190","DOI":"10.1007\/s12471-022-01677-9","article-title":"The benefit of vaccination against COVID-19 outweighs the potential risk of myocarditis and pericarditis","volume":"30","author":"TA Klamer","year":"2022","journal-title":"Neth Heart J"},{"issue":"2","key":"pone.0298272.ref007","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1038\/s41591-021-01630-0","article-title":"Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection","volume":"28","author":"M Patone","year":"2022","journal-title":"Nat Med"},{"key":"pone.0298272.ref008","doi-asserted-by":"crossref","first-page":"103208","DOI":"10.1016\/j.jbi.2019.103208","article-title":"The REDCap consortium: Building an international community of software platform partners","volume":"95","author":"PA Harris","year":"2019","journal-title":"J Biomed Inform"},{"issue":"2","key":"pone.0298272.ref009","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"PA Harris","year":"2009","journal-title":"J Biomed Inform"},{"issue":"1","key":"pone.0298272.ref010","doi-asserted-by":"crossref","first-page":"e2143955","DOI":"10.1001\/jamanetworkopen.2021.43955","article-title":"Frequency of Adverse Events in the Placebo Arms of COVID-19 Vaccine Trials: A Systematic Review and Meta-analysis","volume":"5","author":"JW Haas","year":"2022","journal-title":"JAMA Netw Open"},{"issue":"10","key":"pone.0298272.ref011","doi-asserted-by":"crossref","first-page":"100066","DOI":"10.1016\/j.waojou.2019.100066","article-title":"Time to revisit the definition and clinical criteria for anaphylaxis?","volume":"12","author":"PJ Turner","year":"2019","journal-title":"World Allergy Organ J"},{"issue":"1","key":"pone.0298272.ref012","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1002\/ajmg.c.31543","article-title":"Cardiovascular autonomic dysfunction in Ehlers-Danlos syndrome-Hypermobile type","volume":"175","author":"A Hakim","year":"2017","journal-title":"Am J Med Genet C Semin Med Genet"},{"key":"pone.0298272.ref013","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.autneu.2018.02.006","article-title":"Postural tachycardia syndrome and other forms of orthostatic intolerance in Ehlers-Danlos syndrome","volume":"215","author":"M Roma","year":"2018","journal-title":"Auton Neurosci"},{"key":"pone.0298272.ref014","volume-title":"Stata Statistical Software","author":"StataCorp","year":"2021","edition":"17"},{"volume-title":"A language and environment for statistical computing","year":"2021","author":"Team RC","key":"pone.0298272.ref015"},{"issue":"10","key":"pone.0298272.ref016","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1080\/14779072.2021.1997589","article-title":"Cardiac arrhythmias associated with COVID-19 infection: state of the art review","volume":"19","author":"M Mohammad","year":"2021","journal-title":"Expert Rev Cardiovasc Ther"},{"issue":"1","key":"pone.0298272.ref017","doi-asserted-by":"crossref","DOI":"10.1136\/openhrt-2021-001758","article-title":"Prospective arrhythmia surveillance after a COVID-19 diagnosis","volume":"9","author":"TA Dewland","year":"2022","journal-title":"Open Heart"},{"issue":"12","key":"pone.0298272.ref018","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1038\/s44161-022-00166-x","article-title":"SARS-CoV-2 infection and cardiac arrhythmias","volume":"1","author":"TA Dewland","year":"2022","journal-title":"Nat Cardiovasc Res"},{"issue":"1","key":"pone.0298272.ref019","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1186\/s13223-021-00613-7","article-title":"Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis","volume":"17","author":"S Alhumaid","year":"2021","journal-title":"Allergy Asthma Clin Immunol"},{"issue":"3","key":"pone.0298272.ref020","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.jaip.2021.12.021","article-title":"Population-Based Incidence, Severity, and Risk Factors Associated with Treated Acute-Onset COVID-19 mRNA Vaccination-Associated Hypersensitivity Reactions","volume":"10","author":"E Macy","year":"2022","journal-title":"J Allergy Clin Immunol Pract"},{"issue":"3","key":"pone.0298272.ref021","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/j.jaci.2015.07.048","article-title":"Risk of anaphylaxis after vaccination in children and adults","volume":"137","author":"MM McNeil","year":"2016","journal-title":"J Allergy Clin Immunol"},{"issue":"9","key":"pone.0298272.ref022","doi-asserted-by":"crossref","first-page":"1110","DOI":"10.1080\/09638288.2017.1419294","article-title":"Cognitive, emotional, and behavioral considerations for chronic pain management in the Ehlers-Danlos syndrome hypermobility-type: a narrative review","volume":"41","author":"C Baeza-Velasco","year":"2019","journal-title":"Disabil Rehabil"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0298272","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T17:24:40Z","timestamp":1711041880000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0298272"}},"subtitle":[],"editor":[{"given":"Viacheslav","family":"Kovtun","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2024,3,21]]},"references-count":22,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,3,21]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0298272","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2024,3,21]]}}}