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Potential hypothesized mechanisms include (1) very high antibody generation response, similar to the multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection, (2) anti-idiotype cross-reactive antibody-mediated cytokine expression induction in the myocardium, (3) non-specific innate inflammatory response or a molecular mimicry mechanism between the viral spike protein and an unknown cardiac protein, and (4) immunogen potential of RNA itself in vaccine and adjuvant effect production by cytokine activation of pre-existing autoreactive immune cells (205)
