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

Korean J Intern Med. 2022 Sep;37(5):989-1001. doi: 10.3904/kjim.2022.072. Epub 2022 Aug 22.

Abstract

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.

Conclusion: 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.

Keywords: COVID-19; Drug-related side effects and adverse reactions; Lung diseases, interstitia; Pneumonitis; Vaccines.

Publication types

  • Review

MeSH terms

  • Aged, 80 and over
  • BNT162 Vaccine
  • COVID-19 Vaccines / adverse effects
  • COVID-19* / prevention & control
  • ChAdOx1 nCoV-19
  • Humans
  • Pneumonia*
  • Prospective Studies
  • RNA, Messenger
  • Vaccination

Substances

  • COVID-19 Vaccines
  • RNA, Messenger
  • ChAdOx1 nCoV-19
  • BNT162 Vaccine