Infectious Diseases I Unit, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy.
Paediatric Clinic, I.R.C.C.S. Policlinico San Matteo Foundation, Pavia, Italy.
Int J Infect Dis. 2021 Nov;112:243-246. doi: 10.1016/j.ijid.2021.09.026. Epub 2021 Sep 20.
There is ongoing debate regarding the role of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in asthma exacerbation, and its long-term impact on the lung function of individuals with asthma. In contrast, the potential impact of coronavirus disease 2019 (COVID-19) vaccination on asthma is entirely unexplored.
This study examined a challenging case of severe asthma exacerbation in a 28-year-old female following two doses of the mRNA-based vaccine BNT162b2 (Pfizer-BioNTech) at IRCCS Policlinico San Matteo in Pavia, Italy. The patient, a fourth-year resident at the hospital, was vaccinated in early 2021. She was an occasional smoker with a 10-year history of asthma and seasonal allergic rhinitis. She tested negative for SARS-CoV-2 on several molecular swabs and serology tests.
After receiving the second dose of vaccine, the patient started to experience worsening of respiratory symptoms. Following several episodes and a severe asthma attack, the patient required treatment with mepolizumab, a biologic drug (interleukin-5) antagonist monoclonal antibody.
This single case study is insufficient to draw conclusions about the association between asthma exacerbation and the COVID-19 vaccine. While the cause-effect link between vaccination against SARS-CoV-2 and worsening of asthmatic disease might only be suggested at present, this case is a valuable prompt for further investigation. This is particularly true from the perspective of mass vaccination of adolescents and children currently underway across the globe.
目前，关于严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染在哮喘恶化中的作用及其对哮喘患者肺功能的长期影响，仍存在争议。相比之下，新冠病毒病 2019（COVID-19）疫苗接种对哮喘的潜在影响尚未得到充分探索。
本研究在意大利帕维亚的 IRCCS 圣马特奥综合医院（IRCCS Policlinico San Matteo），对一名 28 岁女性在接种两剂基于 mRNA 的疫苗 BNT162b2（辉瑞-生物科技）后出现严重哮喘恶化的复杂病例进行了研究。该患者是医院的四年级住院医师，于 2021 年初接种疫苗。她偶尔吸烟，患有哮喘和季节性过敏性鼻炎 10 年。她在几次分子拭子和血清学检测中 SARS-CoV-2 检测结果均为阴性。
接种第二剂疫苗后，患者开始出现呼吸道症状恶化。在经历了几次发作和一次严重的哮喘发作后，患者需要接受美泊利单抗（一种白细胞介素-5 拮抗剂单克隆抗体）治疗。
本单病例研究尚不足以得出哮喘恶化与 COVID-19 疫苗之间存在关联的结论。虽然目前仅提示接种 SARS-CoV-2 疫苗与哮喘疾病恶化之间存在因果关系，但该病例为进一步研究提供了有价值的线索。特别是考虑到目前全球正在对青少年和儿童进行大规模疫苗接种。
