An autopsy case of COVID-19-like acute respiratory distress syndrome after mRNA-1273 SARS-CoV-2 vaccination

• Published in: International Journal of Infectious Diseases Vol. 121; pp. 98 - 101
• Main Authors: Yoshimura, Yukihiro, Sasaki, Hiroaki, Miyata, Nobuyuki, Miyazaki, Kazuhito, Okudela, Koji, Tateishi, Yoko, Hayashi, Hiroyuki, Kawana-Tachikawa, Ai, Iwashita, Hiromichi, Maeda, Kazuho, Ihama, Yoko, Hatayama, Yasuyoshi, Ryo, Akihide, Tachikawa, Natsuo
• Format: Journal Article
• Language: English
• Published: Canada Elsevier Ltd 01.08.2022; Elsevier BV; The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases; Elsevier
• Subjects: acute respiratory distress syndrome; autopsy; COVID-19; Infectious and parasitic diseases; RC109-216; vaccine; COVID-19; acute respiratory distress syndrome; vaccine; autopsy
• ISSN: 1201-9712; 1878-3511; 1878-3511
• DOI: 10.1016/j.ijid.2022.04.057

•-An old woman developed interstitial pneumonia after mRNA-1273 vaccination.•-The patient's symptoms, laboratory findings, and images were similar to those of COVID-19.•-Serological and pathological tests were useful in diagnosing vaccine-induced acute respiratory distress syndrome.•-Serum level of antibodies against spike protein was extremely high. We report the first case with COVID-19-like acute respiratory distress syndrome after mRNA-1273 SARS-CoV-2 vaccination. An 88-year-old woman developed dyspnea several hours after vaccination with the second dose of mRNA-1273. She was hospitalized on day nine due to worsening dyspnea. Chest computed tomography showed bilateral ground-glass opacities and consolidations, mainly in the peripheral lung areas. Repeat polymerase chain reaction tests for SARS-CoV-2 were negative, although the serum level of antibodies against spike protein was extremely elevated. Her condition did not improve with high-dose corticosteroids and high-flow nasal cannula oxygen therapy; she died on day 18. Autopsy findings revealed very early-phase diffuse alveolar damage in the whole lung without other lung diseases. The clinical and pathological findings suggested vaccine-induced acute respiratory distress syndrome. Serological and pathological tests might be useful to differentiate the disease from COVID-19.