Case report: Acute exacerbation of interstitial pneumonia related to messenger RNA COVID-19 vaccination

Saori Amiya; Jun Fujimoto; Kinnosuke Matsumoto; Makoto Yamamoto; Yuji Yamamoto; Midori Yoneda; Tomoki Kuge; Kotaro Miyake; Takayuki Shiroyama; Haruhiko Hirata; Yoshito Takeda; Atsushi Kumanogoh

doi:10.1016/j.ijid.2022.01.031

Case report: Acute exacerbation of interstitial pneumonia related to messenger RNA COVID-19 vaccination

Int J Infect Dis. 2022 Mar:116:255-257. doi: 10.1016/j.ijid.2022.01.031. Epub 2022 Jan 19.

Affiliations

¹ Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
² Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.; Department of Immunopathology, WPI, Immunology Frontier Research Center (iFReC), Osaka University, Suita, Osaka, Japan.. Electronic address: jfujimoto@imed3.med.osaka-u.ac.jp.
³ Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.; Department of Immunopathology, WPI, Immunology Frontier Research Center (iFReC), Osaka University, Suita, Osaka, Japan.; Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives（OTRI）, Osaka University, Suita, Osaka, Japan.; Center for Infectious Diseases for Education and Research (CiDER), Osaka University, Suita, Osaka, Japan.

Abstract

Messenger RNA (mRNA) vaccines that protect against COVID-19 are widely used in many countries owing to their high efficacy and safety profiles. Recently, few severe adverse events, such as anaphylaxis and myocarditis, were reported in healthy individuals. The safety of mRNA COVID-19 vaccines has not been adequately studied in patients with interstitial lung disease. We report 2 cases of acute exacerbation of preexisting interstitial pneumonia associated with mRNA COVID-19 vaccination. In both cases, lung disease was stable before the vaccination. Initial responses to steroid therapy were unfavorable, and intravenous cyclophosphamide was administered in both cases. Both patients were diagnosed with vaccine-related exacerbation of interstitial pneumonia based on laboratory results, radiologic features, and the observed clinical course, which lacked other causative events. We suggest that clinicians should note the possibility of acute exacerbation of pneumonia after mRNA COVID-19 vaccination and carefully monitor patients with interstitial lung disease.

Keywords: COVID-19; SARS-CoV-2; acute exacerbation of interstitial pneumonia; case report; mRNA vaccine.

Publication types

Case Reports

MeSH terms

COVID-19 Vaccines / adverse effects
COVID-19* / diagnosis
COVID-19* / prevention & control
Humans
Lung Diseases, Interstitial* / diagnosis
Lung Diseases, Interstitial* / etiology
RNA, Messenger / genetics
SARS-CoV-2
Vaccination / adverse effects

Substances

COVID-19 Vaccines
RNA, Messenger