Kahn Benjamin, Apostolidis Sokratis A, Bhatt Vatsal, Greenplate Allison R, Kallish Staci, LaCava Anthony, Lucas Alfredo, Meyer Nuala J, Negoianu Dan, Ogdie Alexis R, Shashaty Michael G S, Takach Patricia A, Zuroff Leah, Wherry E John, Anesi George L
University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Division of Rheumatology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Crit Care Explor. 2021 Nov 5;3(11):e0578. doi: 10.1097/CCE.0000000000000578. eCollection 2021 Nov.
The U.S. Food and Drug Administration has to date granted approval or emergency use authorization to three vaccines against severe acute respiratory syndrome coronavirus 2 and coronavirus disease 2019. In clinical trials and real-use observational studies, the Pfizer-BioNTech BNT162b2 messenger RNA coronavirus disease 2019 vaccine, as well as the Moderna mRNA-1273 messenger RNA coronavirus disease 2019 vaccine, have demonstrated high efficacy and few adverse events.
A 20-year-old male college student in good health developed tinnitus and hematuria shortly after vaccination and progressed swiftly to a syndrome of: systemic inflammation; acute kidney injury requiring hemodialysis; acute, bilateral, complete sensorineural hearing loss; radiographic evidence of acute multifocal ischemic strokes; pericardial effusion complicated by tamponade physiology requiring pericardial evacuation; pleural effusions requiring evacuation; and systemic capillary leak. An extensive clinical and research investigation, including cytokine analysis, whole blood cytometry by time of flight, and whole exome sequencing, did not reveal a definitive explanatory mechanism.
While the overall safety profile of the BNT162b2 coronavirus disease 2019 vaccine remains excellent for the general population, rare serious events have been reported. In this report, we describe a case of multisystem inflammation and organ dysfunction of unknown mechanism beginning shortly after administration of the first dose of BNT162b2 coronavirus disease 2019 vaccine in a previously healthy recipient.
美国食品药品监督管理局迄今已批准或给予三种针对严重急性呼吸综合征冠状病毒2和2019冠状病毒病的疫苗紧急使用授权。在临床试验和实际使用观察研究中，辉瑞- BioNTech BNT162b2信使核糖核酸2019冠状病毒病疫苗以及莫德纳mRNA - 1273信使核糖核酸2019冠状病毒病疫苗已显示出高疗效且不良事件较少。
一名20岁健康男大学生在接种疫苗后不久出现耳鸣和血尿，并迅速发展为以下综合征：全身炎症；需要血液透析的急性肾损伤；急性双侧完全性感音神经性听力丧失；急性多灶性缺血性中风的影像学证据；心包积液并发心包填塞生理状态需要心包引流；胸腔积液需要引流；以及全身毛细血管渗漏。广泛的临床和研究调查，包括细胞因子分析、飞行时间全血细胞计数和全外显子测序，均未揭示明确的解释机制。
虽然BNT162b2 2019冠状病毒病疫苗对普通人群的总体安全性仍然良好，但已报告了罕见的严重事件。在本报告中，我们描述了一例在先前健康的受种者接种第一剂BNT162b2 2019冠状病毒病疫苗后不久开始出现的机制不明的多系统炎症和器官功能障碍病例。
