Vaccine-induced interstitial lung disease
Interstitial lung disease is the most common and serious complication of the inflammatory muscle diseases It can be caused by long-term environmental exposures or autoimmune diseases such as rheumatoid arthritis, but in some cases the causes remain unknown.
In a study of 545 patients with interstitial lung disease (ILD) in Japan, ~3% of patients reported that COVID-19 vaccination caused an adverse reaction of worsening respiratory symptoms. Four patients experienced acute exacerbations. Two of them had collagen vascular disease-associated ILD, one had nonspecific interstitial pneumonia, another had unclassifiable idiopathic pneumonia, and none had idiopathic pulmonary fibrosis. In addition to adverse reactions, increased prevalence of non-response to vaccine was observed in patients with autoimmune-systemic-disease-related interstitial lung disease (p = 0.009)
Several other cases were described in medical literature two were so severe (males in their 60s) they required intubation. An 82-year-old woman who developed symmetrical ground-glass opacification with spontaneous pneumomediastinum and pneumothorax after second dose of BNT162b2-mRNA vaccine did not survive.
A 60-year-old man presented with dyspnea four days after the second dose of COVID-19 vaccine. He had a history of smoking, asthma-chronic obstructive lung disease (COPD) overlap syndrome, hypertension, complete right bundle branch block and mild mitral regurgitation. Imaging revealed extensive ground-glass opacification (see Figure above). His respiratory condition gradually worsened, which required mechanical ventilation. On the 7th day, the patient was extubated and was slowly improving.
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