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

•-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 leve...

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Published inInternational 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
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Published Canada Elsevier Ltd 01.08.2022
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Abstract •-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.
AbstractList 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.
•-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.
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.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.
Author Ryo, Akihide
Maeda, Kazuho
Iwashita, Hiromichi
Sasaki, Hiroaki
Miyata, Nobuyuki
Hatayama, Yasuyoshi
Miyazaki, Kazuhito
Hayashi, Hiroyuki
Kawana-Tachikawa, Ai
Tachikawa, Natsuo
Okudela, Koji
Tateishi, Yoko
Ihama, Yoko
Yoshimura, Yukihiro
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  givenname: Ai
  orcidid: 0000-0002-3082-5324
  surname: Kawana-Tachikawa
  fullname: Kawana-Tachikawa, Ai
  organization: AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
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  organization: Department of Legal Medicine, Yokohama City University Graduate School of Medicine, Yokohama city, Japan
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  organization: Department of Infectious Disease, Yokohama Municipal Citizen's Hospital, Yokohama city, Japan
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Keywords COVID-19
acute respiratory distress syndrome
vaccine
autopsy
Language English
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Snippet •-An old woman developed interstitial pneumonia after mRNA-1273 vaccination.•-The patient's symptoms, laboratory findings, and images were similar to those of...
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...
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SubjectTerms acute respiratory distress syndrome
autopsy
COVID-19
Infectious and parasitic diseases
RC109-216
vaccine
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Title An autopsy case of COVID-19-like acute respiratory distress syndrome after mRNA-1273 SARS-CoV-2 vaccination
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https://dx.doi.org/10.1016/j.ijid.2022.04.057
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Volume 121
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