Delayed hypersensitivity to the Comirnaty coronavirus disease 2019 vaccine presenting with pneumonitis and rash

Stoyanov, Alex; Thompson, Graeme; Lee, Monique; Katelaris, Connie

doi:10.1016/j.anai.2021.11.014

Cited by 3 publications

(5 citation statements)

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“…We found 12 cases of CV-P in previously published reports through a review of the literature (Table 4) [25][26][27][28][29][30][31][32][33]. Eleven patients developed CV-P after receiving the BNT162b2-mR-NA vaccine and one after receiving the first dose of the Ch-AdOx1 nCoV-19 vaccine.…”

Section: Discussionmentioning

confidence: 98%

“… Case #1-#3, Shimizu et al [ 25 ]; Case #4, Kono et al [ 26 ]; Case #5, Matsuzaki et al [ 27 ]; Case #6 Yoshifuji et al [ 28 ]; Case #7, Piqueras et al [ 29 ]; Case #8, Stoyanov et al [ 30 ]; Case #9 and #10, Amiya et al [ 31 ]; Case #11, Wang et al [ 32 ]; Case #12 Miqdadi et al [ 33 ]. …”

Section: Figureunclassified

“…3, Shimizu et al[25]; Case #4, Kono et al[26]; Case #5, Matsuzaki et al[27]; Case #6 Yoshifuji et al[28]; Case #7, Piqueras et al[29]; Case #8, Stoyanov et al[30]; Case #9 and #10, Amiya et al[31]; Case #11, Wang et al[32]; Case #12 Miqdadi et al [33]. COVID-19, coronavirus disease 2019; DIP, desquamative interstitial pneumonia; ILA, interstitial lung abnormality; IIP, idiopathic interstitial pneumonia; NA, not available; CT, computed tomography; NSIP, nonspecific interstitial pneumonia; OP, organizing pneumonia; DAD, diffuse alveolar damage; MPD, methylprednisolone.…”

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confidence: 99%

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Clinical characteristics of patients with COVID-19 vaccine-related pneumonitis: a case series and literature review

Park

Kim

Park

et al. 2022

Korean J Intern Med

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Background/Aims: Pulmonary toxicities of coronavirus disease 2019 (COVID-19) vaccination are exceedingly rare. However, there are a few reported cases after mRNA vaccination, especially from Asian countries. The purpose of this study was to report the clinical characteristics of patients with COVID-19 vaccine-related pneumonitis (CV-P) and to review cases reported in the literature. Methods: We performed a prospective, observational case series analysis. Results: Eleven patients with a median age of 80 years were enrolled. Ten patients developed CV-P after BNT162b2-mRNA vaccination and one after ChAdOx1 nCoV-19 vaccination. We identified various patterns of CV-P, including transient infiltration, life-threatening acute respiratory distress syndrome, and aggravation of underlying interstitial lung disease. Most patients showed favorable outcomes with good responses to corticosteroid therapy. Conclusions: Identifying the mechanism of CV-P requires further investigation; however, radiological and laboratory findings in our case series support inflammatory dysregulation in the lung parenchyma after vaccination. Clinicians should consider CV-P in patients with atypical lung infiltration, no specific etiologies, and recent COVID-19 vaccination.

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Section: Discussionmentioning

confidence: 98%

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confidence: 99%

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Clinical characteristics of patients with COVID-19 vaccine-related pneumonitis: a case series and literature review

Park

Kim

Park

et al. 2022

Korean J Intern Med

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“…These include cases of eosinophilic pneumonia, hypersensitivity, or other ILDs accountable to either BNT162b or ChAdOx1 nCov-19/AZD1222. 8 9 10 11 12 13 14 15 16 Regarding mRNA-1253 vaccine, Yoshimura et al 17 described a case of an 88-year-old female with dyspnea following 2 nd dose of mRNA-1253 whose postmortem lung specimen revealed proliferative stage of diffuse alveolar damage. To our knowledge, pneumonitis following Ad26.COV2.S vaccination has not been reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, several cases of pneumonitis following COVID-19 vaccines have been published. 8 9 10 11 12 13 These cases, as well as the reports of patients suspicious for vaccine-associated pneumonitis in clinical practice, raised alerts among the Korea Interstitial Lung Diseases Study group, an official study group affiliated with the Korean Academy of Tuberculosis and Respiratory Diseases.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 Vaccine-Associated Pneumonitis in the Republic of Korea: A Nationwide Multicenter Survey

et al. 2023

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Background Recent reports have suggested that pneumonitis is a rare complication following vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, its clinical features and outcomes are not well known. The aim of this study was to identify the clinical characteristics and outcomes of patients with vaccine-associated pneumonitis following vaccination against SARS-CoV-2. Methods In this nationwide multicenter survey study, questionnaires were distributed to pulmonary physicians in referral hospitals. They were asked to report cases of development or exacerbation of interstitial lung disease (ILD) associated with the coronavirus disease 2019 vaccine. Vaccine-associated pneumonitis was defined as new pulmonary infiltrates documented on chest computed tomography within 4 weeks of vaccination and exclusion of other possible etiologies. Results From the survey, 49 cases of vaccine-associated pneumonitis were identified between February 27 and October 30, 2021. After multidisciplinary discussion, 46 cases were analyzed. The median age was 66 years and 28 (61%) were male. The median interval between vaccination and respiratory symptoms was 5 days. There were 20 (43%), 17 (37%), and nine (19%) patients with newly identified pneumonitis, exacerbation of pre-diagnosed ILD, and undetermined pre-existing ILD, respectively. The administered vaccines were BNT162b2 and ChAdOx1 nCov-19/AZD1222 each in 21 patients followed by mRNA-1273 in three, and Ad26.COV2.S in one patient. Except for five patients with mild disease, 41 (89%) patients were treated with corticosteroid. Significant improvement was observed in 26 (57%) patients including four patients who did not receive treatment. However, ILD aggravated in 9 (20%) patients despite treatment. Mortality was observed in eight (17%) patients. Conclusion These results suggest pneumonitis as a potentially significant safety concern for vaccines against SARS-CoV-2. Clinical awareness and patient education are necessary for early recognition and prompt management. Additional research is warranted to identify the epidemiology and characterize the pathophysiology of vaccine-associated pneumonitis.

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Tozinameran

2022

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Delayed hypersensitivity to the Comirnaty coronavirus disease 2019 vaccine presenting with pneumonitis and rash

Cited by 3 publications

References 10 publications

Clinical characteristics of patients with COVID-19 vaccine-related pneumonitis: a case series and literature review

Clinical characteristics of patients with COVID-19 vaccine-related pneumonitis: a case series and literature review

COVID-19 Vaccine-Associated Pneumonitis in the Republic of Korea: A Nationwide Multicenter Survey

Tozinameran

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