Division of Pulmonary, Allergy, and Critical Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
Division of Infectious Diseases, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea.
Korean J Intern Med. 2022 Sep;37(5):989-1001. doi: 10.3904/kjim.2022.072. Epub 2022 Aug 22.
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.
We performed a prospective, observational case series analysis.
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.
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.
背景/目的:新型冠状病毒病 2019(COVID-19)疫苗接种的肺部毒性极为罕见。然而,在接种 mRNA 疫苗后有少数报告病例,尤其是来自亚洲国家的病例。本研究的目的是报告与 COVID-19 疫苗相关的肺炎(CV-P)患者的临床特征,并复习文献中报告的病例。
我们进行了一项前瞻性、观察性病例系列分析。
共纳入 11 例中位年龄为 80 岁的患者。10 例患者在接种 BNT162b2-mRNA 疫苗后发生 CV-P,1 例患者在接种 ChAdOx1 nCoV-19 疫苗后发生 CV-P。我们发现 CV-P 有多种表现形式,包括一过性浸润、危及生命的急性呼吸窘迫综合征和基础间质性肺疾病加重。大多数患者对皮质类固醇治疗反应良好,预后良好。
需要进一步研究明确 CV-P 的发病机制;然而,我们病例系列的影像学和实验室发现支持接种后肺实质的炎症失调。临床医生应考虑在出现非典型肺部浸润、无特定病因且近期接种 COVID-19 疫苗的患者中考虑 CV-P。