Objective Melanoma differentiation-associated gene 5 (MDA5) is a viral RNA sensor induced by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Similarities have been reported between the clinical presentations of coronavirus disease 2019 (COVID-19) pneumonia and anti-MDA5 antibody-positive interstitial lung disease (anti-MDA5-ILD). However, it is unknown whether COVID-19 mRNA vaccines are associated with anti-MDA5-ILD. Methods We retrospectively reviewed consecutive patients with anti-MDA5-ILD admitted to our hospital between April 2017 and March 2022. In addition, we investigated the clinical presentations of patients who developed anti-MDA5-ILD after vaccination with COVID-19 mRNA vaccines. We also examined the annual number of anti-MDA5-ILD cases before and after the COVID-19 vaccination campaign. Results Nine patients with anti-MDA5-ILD were seen during the study period, of whom four developed anti-MDA5-ILD between August and October 2021, approximately 6-12 weeks after vaccination with a COVID-19 mRNA vaccine, a few months after the rapid mRNA COVID-19 vaccination campaign in Japan. None of the four patients had evidence of SARS-CoV-2 infection. The difference in the annual number of anti-MDA5-ILD cases between before and after the COVID-19 vaccination campaign (1.25 ± 0.96 cases per year vs. 4.0 cases per year) was not statistically significant (p = 0.083). Conclusion We encountered four cases of anti-MDA5-ILD after COVID-19 vaccination. Further large population studies are needed to clarify the relationship between anti-MDA5-ILD and vaccination with COVID-19 mRNA vaccines.
We thank Mutoh et al1 for their interest in our study on antimelanoma differentiation-associated gene 5 antibody–positive interstitial lung disease (anti-MDA5-ILD) after vaccination with coronavirus disease 2019 (COVID-19) mRNA vaccines2 and for sharing their clinical experience. Mutoh et al1 reported a case of anti-MDA5-ILD that developed 8 weeks after COVID-19 mRNA vaccination in Japan.
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