Table 1.

Reported cases of MDA5-dermatomyositis developing after COVID-19 vaccine administration

Author/year of publication	Age	Gender	Time to symptom onset	Clinical features	Serologies	COVID-19 vaccine type	Treatments received	Outcomes
Carrasco et al. [9]	58	Male	4 days after unknown dose	Fever Digital tip ischemia and ulceration RP-ILD PTX Pneumomediastinum Pericardial effusion	ANA 1:320 (unknown pattern) MDA5	NA	Steroids Cyclophosphamide IVIG Colchicine Tacrolimus	Died
Gonzalez et al. This report 2022 Case 1	45	Male	2 days after second dose	Fever Heliotrope rash Gottron's papules Erosive retiform rash Polyarthralgia RP-ILD Extensive right arm edema	SSA-52 (Ro-52) MDA5	Moderna (mRNA-1273)	Steroids IVIG Rituximab	Recovered
Case 2	58	Female	7 days after second dose	Fever Gottron's sign Auricular papules Polyarthralgia	MDA5	Covishield (ChAdOx1 nCov-19)	Steroids Mycophenolate mofetil Hydroxychloroquine Cyclophosphamide Rituximab Tofacitinib Tacrolimus Nintedanib	Recovered
Case 3	45	Female	3 days after second dose	Fever Heliotrope rash Gottron's papules Mechanic hands ILD	ANA 1:640 (Homogenous pattern) MDA5	Pfizer (BNT162b2)	Adalimumab** Prednisone Rituximab Tofacitinib PLEX	Recovered
Case 4	28	Female	14 days after second dose	Heliotrope rash Gottron's papules Gottron's sign V-sign Muscle weakness	TIF-1 gamma MDA5	Pfizer (BNT162b2)	Steroids Hydroxychloroquine Mycophenolate mofetil Sulfamethoxazole-trimethoprim (for PCP ppx)	Recovered
Case 5	51	Female	7 days after second dose	Gottron's papules Holster sign Shawl sign ILD	SSA-52 (Ro-52) MDA5	Pfizer (BNT162b2)	Cyclophosphamide Steroids	Recovered
Case 6	54	Female	14 days after first dose	Heliotrope rash Gottron's papules Mechanic hands V-sign Sunburn sign	ANA 1:640 (Fine speckled pattern) SSA-52 (Ro-52) MDA5	Pfizer (BNT162b2)	Steroids Hydroxychloroquine Azathioprine Mycophenolate mofetil	Recovered

ACR American College of Rheumatology, ANA antinuclear antibody, DM dermatomyositis, EULAR European League Against Rheumatism, IIM idiopathic inflammatory myositis, IVIG intravenous immune globulin, MDA5 melanoma differentiation-associated protein 5, NA not available, PCP pneumocystis pneumonia, PLEX plasma exchange, ppx prophylaxis, RP-ILD rapidly progressive interstitial lung disease, SSA Sjogren syndrome A, TIF-1 gamma anti-transcription factor 1 gamma

**Medical history of seropositive rheumatoid arthritis in remission on upadacitinib that was switched to adalimumab once diagnosis of MDA5-DM was made

All cases met 2017 EULAR/ACR classification criteria for adult IIMs and their subgroups