COVID-19 Pneumonia in Vaccinated Population: A Six Clinical and Radiological Case Series

Abstract

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) and its related disease (COVID-19) continue to represent a challenge for humans. To date, vaccination programs have represented an opportunity to navigate the pandemic. However, the advent of new genetic COVID-19 variants has increased more attention representing a worrying threat not only for not vaccinated but also for vaccinated people as virus infections have been shown also in the last ones. Herein, we report different clinical cases and radiological findings of COVID-19 pneumonia in six fully vaccinated patients. Two patients had a history of Rituximab therapy for follicular lymphoma and with persistent positivity for SARS-CoV-2 on nasopharyngeal/oropharyngeal (NP/OP) swabs and with moderate pneumonia on the chest computed tomography (CT). One patient who resulted to be positive to delta variant 8 days after the second vaccination dose, died shortly after. Two patients were hospitalized due to the worsening of fever and dyspnea in presence of mild pneumonia on CT. In one patient mild pneumonia was found on the chest-CT performed after a lipothymic episode associated with chest pain and positive NP/OP swab tested for SARS-CoV-2. These data suggested that in fully vaccinated people, caution should be preserved, and the use of masks and social distancing should be continued in all closed environments. However, further clinical trials should be done to better understand how various factors can influence vaccine immunogenicity as the presence of virus mutations, age factors, and the presence of an immunocompromised state.

SARS-CoV-2 RT-qPCR testing of pooled saliva samples: a case study of 824 asymptomatic individuals and a questionnaire survey in Japan

“…Although SARS-CoV-2 vaccines reduce the risk of symptomatic and severe disease and infection (46, 47), breakthrough infections occur (3-5) and vaccine effectiveness against transmission is decreased for the delta variants (48, 49). Additionally, vaccine protective effects decline considerably after six months, especially in older people, according to studies in the UK (50) and Israel (51).…”

“…Although vaccination programs have progressed in many countries, daily infections and hospitalizations are still high globally (1,2). Moreover, breakthrough infections in fully vaccinated individuals have been reported, indicating that such people can still contract and transmit the virus (3)(4)(5). One of the challenges in controlling this disease is that the spread of SARS-CoV-2 infection occurs not only in symptomatic patients but also in asymptomatic carriers, including many who later develop symptoms (presymptomatic cases) (6)(7)(8).…”

SARS-CoV-2 RT-qPCR testing of pooled saliva samples: A case study of 824 asymptomatic individuals and a questionnaire survey in Japan

“…Although SARS-CoV-2 vaccines reduce the risk of symptomatic and severe disease and infection [ 46 , 47 ], breakthrough infections occur [ 3 – 5 ] and vaccine protective effects decline considerably after six months, especially in older people, according to studies in the UK [ 48 ] and Israel [ 49 ]. The recent surge of infections with delta and omicron variants across the world demonstrates that vaccine efficacy decreases over time and with immune escape acquired by viral mutations [ 50 – 53 ].…”

“…Although vaccination programs have progressed in many countries, daily infections and hospitalizations are still high globally [ 1 , 2 ]. Moreover, breakthrough infections have been reported in fully vaccinated individuals, indicating that such people can still contract and transmit the virus [ 3 – 5 ]. One of the challenges in controlling this disease is that the spread of SARS-CoV-2 infection occurs not only in symptomatic patients but also in asymptomatic carriers, including many who later develop symptoms (presymptomatic cases) [ 6 – 8 ].…”

Differences in Dynamics of Lung Computed Tomography Patterns between Survivors and Deceased Adult Patients with COVID-19

“…At the time of writing, no specific etiotropic therapy has been described and, despite quarantine measures, and different mRNA (mRNABNT162b2-Pfizer-BioNtech, Manhattan, NY, USA; mRNA-1273-Moderna, Cambridge, MA, USA) or vector-based (JNJ-78436735-Johnson & Johnson, New Brunswick, NJ, USA; ChAdOx1-S-AstraZeneca, Cambridge, England; Gam-COVID-Vac-Gamaleya NRC of Epidemiology and Microbiology, Moscow, Russia) vaccines, developed and applied on various scales, the number of cases in the world continues to increase by 257,100 daily (in the Russian Federation-25,700) [21]. It is worth noting that concern remains because, according to data of Brogna et al and several authors, the rapid spread of new virus genetic variants (e.g., Delta) and the absence of an effective immune response leads to an increase in the number of infections in fully vaccinated people [22]. Besides, the actual number of infections may be significantly higher due to insufficiently effective and widespread diagnostics.…”