COVID‐19 mRNA vaccine‐related interstitial lung disease: Two case reports and literature review

Abstract

The Pfizer‐BioNTech mRNA vaccine (BNT162b2) is an effective and well‐tolerated coronavirus disease 2019 (COVID‐19) vaccine. However, rare adverse events have been reported. We report two cases of COVID‐19 mRNA vaccine‐related interstitial lung disease (ILD). A 67‐year‐old man and a 70‐year‐old man with underlying ILD presented to our hospital with a few days of fever and respiratory symptoms after receiving the BNT162b2 vaccine. Drug‐related pneumonitis due to the COVID‐19 mRNA vaccine was diagnosed. One case was diagnosed with lymphocytic alveolitis by bronchoalveolar lavage fluid and transbronchial lung cryobiopsy. Both patients were successfully treated with corticosteroids, and they attended outpatient clinics thereafter. Although the safety and efficacy of COVID‐19 vaccines have been established, further studies are needed to estimate long‐term data and reports of rare adverse reactions. We present the clinical course of two cases, review previously published case reports on COVID‐19 mRNA vaccine‐related ILD and discuss the relevant findings.

Acute respiratory distress syndrome secondary to COVID-19 mRNA vaccine administration in a pregnant woman: A case report

“… 12 This patient shared similar features with the eight patients who developed lung injury post COVID-19 vaccination and responded favorably to steroids. 3 , 12 , 16 - 18 A past SARS-CoV-2 infection may have evoked a vigorous immune response after vaccination, resulting in respiratory distress syndrome in our patient. Hence, it is also plausible that this patient's diagnosis was purely fortuitous.…”

Thrombocytopenia and pneumonitis associated with BNT16B2b2 mRNA COVID-19 vaccine: A case report

“…With the increase in the administration of SARS-CoV-2 vaccines worldwide, several adverse reactions have been reported. Vaccination-induced pneumonitis seems to be rare, and to the best of our knowledge, only five cases have been reported so far ( Table 1 ) ( Yoshifuji et al, 2022 , Park et al, 2022 , Farooq et al, 2022 , So et al, 2022 ). In three cases, pneumonitis appeared within a few days after administration of the second dose, and patients experienced fever, cough, and dyspnea.…”

“…Accumulated case reports have revealed several adverse effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. Although thrombocytopenia is relatively common, vaccination-induced pneumonitis is rare, with only five cases reported to date ( Yoshifuji et al, 2022 , Park et al, 2022 , Farooq et al, 2022 , So et al, 2022 ). Here we report the case of a patient who developed thrombocytopenia and pneumonitis concurrently after receiving a SARS-CoV-2 vaccine.…”

COVID-19 and interstitial lung diseases: A multifaceted look at the relationship between the two diseases

“…To date, case-based information has been accumulated, starting with the first case report of vaccine-related ILD induced by an mRNA vaccine [ 174 ]. These cases have consistently shown that ILD occurred within 1-10 days after the first or second shot of the vaccine and sometimes improved spontaneously [ 175 , 176 , 177 ] but sometimes was accompanied by respiratory failure and treated with corticosteroid (methylprednisolone 0.5-1mg/kg and/or pulse therapy) [ 177 , 178 , 179 , 180 , 181 , 182 ]. The major radiological findings are GGO and consolidation represented by an HP or OP pattern [ 175 , 181 ].…”

“…These cases have consistently shown that ILD occurred within 1-10 days after the first or second shot of the vaccine and sometimes improved spontaneously [ 175 , 176 , 177 ] but sometimes was accompanied by respiratory failure and treated with corticosteroid (methylprednisolone 0.5-1mg/kg and/or pulse therapy) [ 177 , 178 , 179 , 180 , 181 , 182 ]. The major radiological findings are GGO and consolidation represented by an HP or OP pattern [ 175 , 181 ]. Histopathological lymphocytic alveolitis, or OP, was proven in some of these cases [ 181 , 182 ].…”