ABSTRACT
We report the case of a 59-year-old man with squamous cell carcinoma (SCC) of the right mandibular gingiva, who presented with bilateral cervical lymphadenopathy (CLA) after mRNA coronavirus disease 2019 (COVID-19) vaccination. The patient was diagnosed. Imaging studies performed prior to surgery revealed bilateral CLA and axillary lymphadenopathy (LA) ipsilateral to the vaccination site. Fine-needle aspiration (FNA) biopsy of the left CLA revealed reactive lymph nodes. The patient underwent surgical intervention for the malignant tumor, and the specimen was sent for histopathologic evaluation. The biopsy-proven cancer stage was pT3N0Mx. Positron emission tomography (PET-CT), performed six months after surgery, showed persistent bilateral CLA. However, FNA of the left axillary LA once again showed no evidence of metastasis or recurrence. Since the treatment plan may change based on the type of LA, it is important to figure out whether an mRNA vaccine has been administered to patients with head and neck cancer.
ABSTRACT
We report the case of a 59-year-old man with squamous cell carcinoma (SCC) of the right mandibular gingiva, who presented with bilateral cervical lymphadenopathy (CLA) after mRNA coronavirus disease 2019 (COVID-19) vaccination. The patient was diagnosed. Imaging studies performed prior to surgery revealed bilateral CLA and axillary lymphadenopathy (LA) ipsilateral to the vaccination site. Fine-needle aspiration (FNA) biopsy of the left CLA revealed reactive lymph nodes. The patient underwent surgical intervention for the malignant tumor, and the specimen was sent for histopathologic evaluation. The biopsy-proven cancer stage was pT3N0Mx. Positron emission tomography (PET-CT), performed six months after surgery, showed persistent bilateral CLA. However, FNA of the left axillary LA once again showed no evidence of metastasis or recurrence. Since the treatment plan may change based on the type of LA, it is important to figure out whether an mRNA vaccine has been administered to patients with head and neck cancer.
ABSTRACT
Autoimmune hepatitis (AIH) is a chronic, autoimmune disease of the liver that occurs when the body's immune system attacks liver cells, causing the liver to be inflamed. AIH is one of the manifestations of a coronavirus disease 2019 (COVID-19), as well as an adverse event occurring after vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Few cases of AIH have been described after vaccination with two messenger RNA (mRNA)-based vaccines-BTN162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)-against SARS-CoV-2. Herein, we report a case of AIH occurring after Pfizer-BioNTech COVID-19 vaccine. A 27-year-old female presented with jaundice and hepatomegaly, appearing 14 days after receiving the second dose of Pfizer-BioNTech vaccine. Her laboratory results showed abnormal liver function with high total immunoglobulin G level. She was diagnosed with AIH with histologic finding and successfully treated with oral prednisolone. We report an AIH case after COVID-19 vaccination in Korea.
Subject(s)
COVID-19 , Hepatitis, Autoimmune , Adult , Autoimmunity , BNT162 Vaccine , COVID-19 Vaccines/adverse effects , Female , Hepatitis, Autoimmune/diagnosis , Hepatitis, Autoimmune/drug therapy , Hepatitis, Autoimmune/etiology , Humans , SARS-CoV-2 , Vaccination/adverse effects , mRNA VaccinesABSTRACT
BACKGROUND/AIMS: We measured the association between underlying chronic hepatitis B (CHB) and antiviral use with infection rates among patients who underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing. METHODS: In total, 204,418 patients who were tested for SARS-CoV-2 between January and June 2020 were included. For each case patient (n = 7,723) with a positive SARS-CoV-2 test, random controls (n = 46,231) were selected from the target population who had been exposed to someone with coronavirus disease 2019 (COVID-19) but had a negative SARS-CoV-2 test result. We merged claim-based data from the Korean National Health Insurance Service database collected. Primary endpoints were SARS-CoV-2 infection and severe clinical outcomes of COVID-19. RESULTS: The proportion of underlying CHB was lower in COVID-19 positive patients (n = 267, 3.5%) than in COVID-19 negative controls (n = 2482, 5.4%). Underlying CHB was associated with a lower SARS-CoV-2 positivity rate, after adjusting for comorbidities (adjusted odds ratio [aOR] 0.65; 95% confidence interval [CI], 0.57-0.74). Among patients with confirmed COVID-19, underlying CHB tended to confer a 66% greater risk of severe clinical outcomes of COVID-19, although this value was statistically insignificant. Antiviral treatment including tenofovir and entecavir was associated with a reduced SARS-CoV-2 positivity rate (aOR 0.49; 95% CI, 0.37-0.66), while treatment was not associated with severe clinical outcomes of COVID-19. CONCLUSIONS: Underlying CHB and antiviral agents including tenofovir decreased susceptibility to SARS-CoV-2 infection. HBV coinfection did not increase the risk of disease severity or lead to a worse prognosis in COVID-19.
Subject(s)
COVID-19/pathology , Hepatitis B, Chronic/pathology , Adult , Aged , Aged, 80 and over , Antiviral Agents/therapeutic use , COVID-19/complications , COVID-19/epidemiology , COVID-19/virology , Case-Control Studies , Cohort Studies , Databases, Factual , Female , Guanine/analogs & derivatives , Guanine/therapeutic use , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/drug therapy , Hepatitis B, Chronic/epidemiology , Humans , Male , Middle Aged , Odds Ratio , Republic of Korea/epidemiology , Risk , Severity of Illness Index , Tenofovir/therapeutic use , Young AdultABSTRACT
With the rapidly spreading coronavirus disease 2019 (COVID-19) pandemic over the past few months, the world is facing an unprecedented crisis. Innumerable lives have been lost to this novel infectious disease, the nature of which supersedes conventional medical understanding. The COVID-19 pandemic is not just a global health crisis, several aspects of life in the post-COVID-19 era are also being contemplated. Experts in unison are warning that the upcoming changes in all areas of life could potentially be far more drastic than ever experienced in the entire human civilization. The medical community is no exception, and therefore, personnel involved in forensic medicine also need to be adequately prepared for the future. Forensic medicine is a branch of medicine dedicated to one of the most important stages of the human lifecycle and has always been at the forefront in times of unprecedented social change. The autopsy, one of the most important tools of forensic medicine, is also useful to infectious diseases because it identifies the causal relationship between death and infection, reveals medical and epidemiological knowledge, and provides objective evidence for legal disputes. We present new autopsy guidelines in forensic medicine, formulated based on the various infectious diseases that we presently live with and may encounter in the future. In formulation of these guidelines several considerations have been taken into account, namely, the role forensic pathologists should play in the post-COVID-19 era and the necessary preparations as well as the support needed from society to fulfill that role. The present COVID-19 outbreak should be a starting point for formulating improvements in current practices in forensic science, including autopsy biosafety practices and the medicolegal death investigation system.