Acute exacerbation of idiopathic pulmonary fibrosis after SARS-CoV-2 vaccination

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has spread worldwide and coronavirus disease 2019 remains a top health concern. Several SARS-CoV-2 vaccines have been produced and are playing great roles in the prevention of infection and worsening to a severe state, and in improving mortality [1]. However, some concerns about adverse effects related to SARS-CoV-2 vaccination have been raised. Recently, various adverse effects have been reported, but there is little data on adverse effects on the lungs [2].

Two cases of acute respiratory failure following SARS‐CoV‐2 vaccination in post‐COVID‐19 pneumonia

“…Myall et al reported that some COVID‐19 patients experience persisting symptoms and OP pattern pneumonitis, 8 and judging from the clinical course of the cases reported here, BAL results and pathological results (in the second case only), perhaps the major pathophysiology could have been recurrent OP rather than AE‐ILD. The latter implies the possibility of AE‐ILD, as we recently reported in a case study of AE of underlying fibrotic ILD 9 . A similar case has been reported by Ghincea et al 10 The first patient here is suspected to have had pre‐existing ILD and in the second patient, a previous chest x‐ray showed reticulation in the lower lung fields, which raised the possibility of AE of RA associated with ILD.…”

“…The latter implies the possibility of AE-ILD, as we recently reported in a case study of AE of underlying fibrotic ILD. 9 A similar case has been reported by Ghincea et al 10 The first patient here is suspected to have had pre-existing ILD and in the second patient, a previous chest x-ray showed reticulation in the lower lung fields, which raised the possibility of AE of RA associated with ILD. Post-COVID-19 ILD should also be considered when discussing this, although such cases sometimes improve over time and it is questionable whether these two cases had chronic fibrotic ILD at the moment of vaccination.…”

Short and Long-Term Impact of COVID-19 Infection on Previous Respiratory Diseases

“…Surprisingly, some cases of acute exacerbation after COVID-19 vaccination have been described in ILDs. 191 , 192 , 193 The benefit of vaccination is over the potential side effects of the vaccine, but physicians must monitor closely those patients that present respiratory worsening after vaccination.…”

Combination of acute exacerbation of idiopathic nonspecific interstitial pneumonia and pulmonary embolism after booster anti-COVID-19 vaccination

“…Similarly, a potential association of AE and the first dose of an mRNA COVID-19 vaccination has recently been observed in a 72-yr old male IPF patient successfully treated with glucocorticoids [ 8 ]. This association has further been confirmed by the case of a 84-yr old male patient affected by f-ILD after receiving the second of an mRNA vaccine [ 9 ]. In line with these previous observations, our findings reinforce the triggering role of anti-COVID-19 vaccination on ILD progression suggesting that such an adverse event may occur even later and despite the patient well tolerated the first two doses of immunization.…”