• Haas A
• McCoy M
• Rufolo-Dreher K

• Chiropractors
• COVID-19 / epidemiology
• Malpractice
• Patient Safety
• Risk Management
• Thrombosis
• Virus Diseases

Background: The SARS-CoV-2 spike protein has demonstrated interactions with vascular endothelial cells, leading to inflammation, thrombosis, and microvascular damage. These interactions are relevant for chiropractors due to their potential overlap with symptoms commonly seen in practice, such as headaches and neck pain, which can mimic vascular events like strokes. The increasing prevalence of vascular complications, post-infection or postvaccination, underscores the need for vigilance in chiropractic care.

Objective: To explore the implications of SARS-CoV-2 spike protein exposure on vascular biology and its impact on chiropractic practice, with a focus on clinical evaluation, risk management, and malpractice defense strategies. Methods: A literature review was conducted to analyze the pathophysiological effects of SARS-CoV-2 spike protein, data from vaccine adverse event reporting systems, and trends in vascular events post-infection or vaccination. Additionally, malpractice claim trends in the chiropractic profession were discussed with related experts for insights into real-world implications.

Results: Spike protein interactions with ACE2 receptors in vascular endothelial cells can lead to systemic vascular damage, presenting as neurological, espiratory, gastrointestinal, musculoskeletal, or renal symptoms. Reports suggest an increase reporting of strokes and vascular complications, particularly in younger populations, post-infection and vaccination emphasizing the importance of differential diagnosis and timely referrals.

Conclusion: Chiropractors are advised to maintain a high index of suspicion for vascular events when evaluating patients with history and symptoms that may overlap with spike protein-related pathology. Proactive risk management strategies, including thorough assessments and appropriate referrals, are essential to mitigate malpractice risks and ensure patient safety.

Keywords: Chiropractic, SARS-CoV-2, Spike Protein, Vascular Biology, Risk Management, Malpractice, Thrombosis, Endothelial Dysfunction, Patient Safety

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