Fatal COVID-19 soon after 2nd dose of Pfizer vaccine in an 88-year-old male

An 88-year-old male patient was brought to the emergency department on July 25, 2021, with complaints of shortness of breath, headache, cough, and generalized body weakness. He was screened for SARS-CoV-2, and he tested negative on the rapid antigen test. A subsequent nasopharyngeal swab for the reverse transcription-polymerase chain reaction (RTPCR) test for SARS-CoV-2, however, yielded positive results. He presented with blood pressure (BP) of 136/62 millimeters of mercury (mmHg), a pulse of 113 per minute, oxygen saturation of 52% at room air, a body temperature of 37.3°C, and blood sugar at 6.2 mmol/lite. An examination of the respiratory system revealed coarse crackles with decreased air entry in both lung fields and all other systems were within normal limits. His medical history included diagnosis with benign prostatic hyperplasia (BPH) after a prostate biopsy in 2015. He received the first dose of the Pfizer-BioNTech vaccine on June 8, 2021, and the second dose on July 20, 2021. After admission, Oxygen saturation improved from 52% on room air to 90% on a face mask with oxygen at 10 liters per minute flow. The following day, his blood investigation showed hemoglobin at 11.8 mmol/dl, a white cell count of 7.59 × 109 /l, platelets at 204 × 109 /l, C-reactive protein (CRP) at 214 mg/l, urea at 12.7 mmol/l, creatinine at 113 µmol/l, and eGFR (CKD-EPI formula) at 51 ml/min/1.73m2 . A chest x-ray revealed diffuse bilateral patchy infiltration. He was transferred to the COVID-19 ward and started with dexamethasone 6mg, low molecular weight heparin 40mg, and azithromycin 500 mg. He moved from face mask to high-flow nasal cannula (HFNC) oxygen therapy because he was unable to maintain the target (SpO2 ≥90%) oxygen saturation. He continuously deteriorated despite optimum treatment and died on July 27, 2021. 

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REFERENCE

Vaccine Breakthrough Infections of SARS-Cov-2: A Case Report

Ramprakash Kaswa. Vaccine Breakthrough Infections of SARS-Cov2: A Case Report. Ethiop J Health Sci. 2021;32 (1):201. 

doi:http://dx.doi.org/10.4314/ejhs.v32i1. 20 

Contact: Ramprakash Kaswa. Department of Family Medicine and Rural Health, Walter Sisulu University, South Africa *Email: rp.kaswa@gmail.com

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