Medical Case Reports

A 50-year-old multiple-sclerosis patient fails to mount a humoral response after the first, second and third Moderna vaccination and even after COVID-19. A 50-year-old female with relapsing remitting multiple sclerosis since 2013, treated with ocrelizumab since 2018, was  vaccinated with Spikevax (Moderna) in April and May 2021  and received the booster vaccination in October. One to two weeks prior to the ocrelizumab infusions in March and September 2021 the patient was B-cell depleted.  Eleven days after the booster vaccination the patient was tested positive for SARS-CoV-2 by PCR. She experienced symptoms of dyspnea and fever and was admitted to the hospital for eleven days where she was treated with oxygen and dexamethasone.  After each vaccination and even  28 days after third vaccination and 17 days after positive SARS-CoV-2 PCR, the patient remained negative for anti-RBD as well as anti-nucleocapsid protein antibodies. The patient fully recovered from COV...

  A 67-year-old physician with a past history of hypertension, allergic rhinitis and hepatic hemangioma for 10 years received the first dose of ChAdOx1nCov-19 vaccine on 2021/3/22. Three days later, he presented with fever, up to 39 o C, combined with general soreness.  His fever subsided after a pain reliever, occurred again 9 days later and subsided again.  Neither leukocytosis nor a higher C-reactive protein (CRP) level was noted at that time, but he developed a fever again two days later and subsequently  tested for  significantly more elevated  inflammatory markers (C RP level of 148.56 mg/L (reference range <5 mg/L) and procalcitonin C of 3.1 ng/ml (reference range <0.5 ng/mL), ALT and AST slightly elevated). His COVID-19 nasopharyngeal swab test was still negative. Both abdominal echography and computed tomography of the abdome n showed abscesses at left lateral segment of the liver. The pus smear revealed Gram-negative bacilli that was la...

  Two weeks after receiving the third injection of the CoronaVac COVID-19 vaccine, a  77-year-old male with eruptive skin lesions was admitted to a clinic in Turkey. He complained of arthralgia, myalgia, and general fatigue and also experienced intestinal symptoms such as bloody diarrhea and abdominal pain. He reported a mildly itchy rash with his first (5 month prior) and second (4 month prior) immunizations, without fever, difficulty breathing, edema, oliguria, or other systemic symptoms.  Dermatologic examination revealed diffuse palpable, tender, non-blanching violaceous coalescent patches on the thighs, calves, feet, and hands. There were also bullous hemorrhagic lesions distributed bilaterally on the extensor sides of the lower legs and feet.  Pathologic laboratory testing revealed elevated C-reactive protein levels of 60 mg/L (normal: 6). D-dimer values and other tests were normal.  Autoimmune workup revealed no pathologic findings. Screenings for vi...

A 64-year-old lady with long standing history of migraine and recently diagnosed hypertension on amlodipine, presented with history of continuous excruciating headache and vomiting of 10 days duration. Five days after onset of headache, she developed drowsiness and difficulty in walking. She had received two doses of COVISHIELD (AstraZeneca, ChAdOx1) vaccine, 2 months back. On examination, patient had  significant vision impairment  in both eyes with normal pupillary reflexes,  quadriplegia  and recurring focal seizures involving right upper limb. She tested positive for SARS-CoV-2. Repeat  MR angiogram showed widespread vasoconstriction of intracranial blood vessels suggestive of Reversible Cerebral Vasoconstriction Syndrome (RCVS).  CSF analysis was normal. Although patient was diagnosed with COVID 19, patient did not complain of cough, breathlessness or fever. Oxygen saturation  in room air was 92% and CT chest showed m...

A 90-year old woman weighting 40.5kg (89.3 pounds) develops anorexia after the first dose of the COVID-19 Pfizer vaccine (0.3 ml containing 30μg of mRNA). Vital records showed abrupt increases in the body temperature, systolic and diastolic blood pressure, and pulse, and decreases in the intake of meals and drinks and body weight. The patient lost 1/4 of her body weight by the time of death 28 weeks after the COVID-19 vaccination.  The patient also experienced hallucinations and decreased mental status, as well as decreased SpO 2  levels.  One month before death, her status was changed from level 2 (partial assistance) to level 5 (bedridden).  Before the injection her vitals were steady with exception of short-termed changes because of minor illnesses. Vital records restricted to the last 6 months (180 days;  Figure 2 ) show the pre-injection horizontal regression line, large + level change for temperature, pressures, and pulse, and – level change for meals and ...

A 61-year-old man with a history of arterial hypertension (PA 145/95 mmHg) and obesity with a body mass index (BMI) of 37.11 was vaccinated with a double dose of mRNA vaccine, but 4 months after the 2nd dose presented with dyspnea, cough, and fever (38°C). Four days after his nasopharyngeal/oropharyngeal (NP/OP) swabs tested positive for SARS-CoV-2 he came to the emergency room with a saturation oxygen level (SO2) at 84%. He continued to test positive for SARS-CoV-2 on NP/OP swabs with detection of the delta variant. Laboratory examination showed a high white blood count, elevated lactated dehydrogenase enzyme (LDH) (750 U/L), elevation of the C-reactive protein (CRP) (26.3 mg/dl), and a mild elevation of the liver aspartate aminotransferase (AST) (61 U/L) (normal value 0–34 U/L).  A chest CT scan showed a typical central and peripheral distribution of GGO COVID-19 pneumonia (CT-SS score of 16/20).  The other laboratory values were in the normal range.  Te...

The clinical course of COVID-19 depends on the complex interaction between genetic and environmental factors which might result in immune hyperactivation or dysregulation. Risk factors for severe outcomes include  cardiovascular and renal diseases, hypertension and diabetes, old age and host genetics.   Several genome-wide association studies  identified candidate genes and non-coding regions associated with the severity of COVID-19 and post-COVID sequelae.   Vaccine effectiveness may fail for individuals with particular genetics and we need more studies and more medical case reports to develop personalized preventative and curative approaches. Until then we can read the news. Valentina Boscardin , an 18 year old Brazilian model  (represented by Ford Models agency) died due to COVID complications despite being fully vaccinated against COVID. She was healthy before falling ill with the virus. Valentina Boscardin Mendes suffered a fatal thrombosis on Sun...

An 18-year-old woman started experiencing symptoms 9 days after vaccination.  She checked into the emergency room complaining of severe headaches and extreme light sensitivity. A CT scan and neurological tests found nothing, so doctors discharged her and recommended to return in 15 days for further tests. But she returned to the hospital just two days later. She now suffered from paralysis in at least one part of her body. This time she was diagnosed with  cavernous sinus thrombosis , meaning a blood clot in the space between the eye sockets and brain. It blocked the primary vein between her head and the heart. Doctors also discovered that she had a brain bleed . She underwent two surgeries, one to remove the blood clot and the second to relieve pressure in her head caused by the bleeding. But the damage was done.  She died 5 days later,  She was previously healthy and was not taking any medications.  REFERENCES Camilla, who died at the age of 18 after AstraZene...

Why do people die from COVID-19 despite vaccination?  There is no comprehensive explanation for this yet. A new Morbidity and Mortality Weekly Report (MMWR) emphasizes the usual risk factors: 36 people that died from fatal breakthroughs were either age 65 or older or had at least one of these conditions: diabetes mellitus, immunosuppression, chronic kidney disease, chronic liver disease, chronic neurologic disease, chronic cardiac disease, or chronic pulmonary disease. Fatal breakthrough cases under 65 and even under 18 have been previously reported but no details were given yet.  Among 1,228,664 persons who completed primary vaccination during December 2020–October 2021, severe COVID-19–associated outcomes (189, 0.015%) or death (36, 0.0033%) were rare. Risk factors for severe outcomes included age ≥65 years, immunosuppressed, and six other underlying conditions. All persons with severe outcomes had at least one risk factor; 78% of persons who died had at least four. Title:...

An 18-year-old female was admitted to a hospital after she was experiencing 'thunder-clap' headaches,  the "worst headache" she had ever experienced,  two weeks after receiving her first dose of AstraZeneca Covid vaccine. An inquest heard the headaches were the result of thrombosis in her sinus cavity.  Because of her low platelet count, doctors initially ruled out a brain hemorrhage. She suffered all of the "common" side effects of the vaccine but hoped these would last approximately 12 to 18 hours, the inquest heard. But two weeks later she was "screaming in pain" with the "worst headache" she had ever experienced. Despite this, a CT scan was reported as "normal". Three days after her admission, she was administered a dose of platelets and her inquest heard that she began to rapidly deteriorate. She suffered from fits and was "not responding to seizure control", the inquest heard. She was then incubated and put on ...

There were four fatalities among 65  fully vaccinated and boosted ( FV&B )  COVID-19 patients at an acute-care hospital system in Southeastern Michigan. In the FV&B cohort that required ICU-level care (n=11), 7 (63.6%) were male with a median age of 71 (66.5, 76.5). 5 (45.5%) were vaccinated with three consecutive Pfizer immunizations, 4 (36.4%) received three doses of the Moderna vaccine, and 2 (18.2%) received two Janssen vaccines. 4 (36.4%) died, 3 (27.2%) were discharged to a Skilled Nursing Facility (SNF), and 2 (18.2%) were discharged home. This data was collected b etween August 12th, 2021 and December 6th, 2021, for 4,571 patients with a primary diagnosis of COVID-19 who required inpatient treatment at an acute-care hospital system in Southeastern Michigan. Of the 4,571 encounters requiring hospitalization, 65(1.4%) were FV&B and 2,935(64%) were UV Despite older age (median 74 vs 58 years old), higher rate of pre-existing ESRD (18.5% vs 1.8%), higher ...

A 65-year-old woman experienced mild abdominal pain shortly after  receiving the first dose of Moderna-COVID-19 vaccine. She tested negative for hepatitis A virus, human immunodeficiency virus, cytomegalovirus, Epstein-Barr virus and herpes simplex virus type 1 and 2, as well as hepatitis B, C and E viruses. Her blood tests and thyroid function were normal,  except elevated ALT/AST and positive antinuclear antibody.   Five weeks after vaccination, the patient presented with jaundice and choluria. Liver profile was worsening, and IgG levels were now elevated.    Percutaneous liver biopsy was performed, revealing a marked expansion of the portal tracts due to dense inflammatory infiltrate, with aggregates of plasma cells;  The score of simplified diagnostic criteria of the International Autoimmune Hepatitis Group was 8, indicative of autoimmune hepatitis (AIH). Treatment with prednisolone 60 mg/day was started with a quick improvement of liver ...