Four cases of cytokine storm after COVID-19 vaccination: Case report

Kazuhiro Murata; Naoki Nakao; Naoki Ishiuchi; Takafumi Fukui; Narutaka Katsuya; Wataru Fukumoto; Hiroko Oka; Naotaka Yoshikawa; Takafumi Nagao; Akira Namera; Naoya Kakimoto; Naohide Oue; Kazuo Awai; Kanji Yoshimoto; Masataka Nagao

doi:10.3389/fimmu.2022.967226

Four cases of cytokine storm after COVID-19 vaccination: Case report

Front Immunol. 2022 Aug 15:13:967226. doi: 10.3389/fimmu.2022.967226. eCollection 2022.

Authors

Kazuhiro Murata^{1

2}, Naoki Nakao², Naoki Ishiuchi¹, Takafumi Fukui³, Narutaka Katsuya¹, Wataru Fukumoto¹, Hiroko Oka¹, Naotaka Yoshikawa², Takafumi Nagao², Akira Namera^{1

2}, Naoya Kakimoto^{1

4}, Naohide Oue^{1

3}, Kazuo Awai^{1

5}, Kanji Yoshimoto^{2

6}, Masataka Nagao^{1

2}

Affiliations

¹ Center for Cause of Death Investigation Research Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
² Department of Forensic Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
³ Department of Molecular Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
⁴ Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
⁵ Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
⁶ Department of Food Sciences and Biotechnology, Graduate School of Science and Technology, Hiroshima Institute of Technology, Hiroshima, Japan.

Abstract

The global coronavirus disease 2019 (COVID-19) pandemic has led to the rapid development of vaccines against this disease. Despite the success of the international vaccination program, adverse events following vaccination, and the mechanisms behind them, remain poorly understood. Here we present four cases of death following receipt of a second dose of COVID-19 vaccine, with no obvious cause identified at autopsy. Using RNA sequencing, we identified genes that were differentially expressed between our post-vaccination cases and a control group that died of blood loss and strangulation. Three hundred and ninety genes were found to be upregulated and 115 genes were downregulated in post-vaccination cases compared with controls. Importantly, genes involved in neutrophil degranulation and cytokine signaling were upregulated. Our results suggest that immune dysregulation occurred following vaccination. Careful observation and care may be necessary if an abnormally high fever exceeding 40°C occurs after vaccination, even with antipyretic drugs.

Keywords: COVID-19; RNA sequencing; immunology; side effects; vaccination.

Publication types

Case Reports

MeSH terms

COVID-19 Vaccines / adverse effects
COVID-19*
Cytokine Release Syndrome
Humans
Pandemics / prevention & control
Vaccination / adverse effects
Vaccination / methods

Substances

COVID-19 Vaccines