ABSTRACT
Acute respiratory distress syndrome (ARDS) and pulmonary fibrosis (PF) are increasingly identified as complications of coronavirus disease 2019 (COVID-19) infection, the latter being managed with tapering dose glucocorticoids. Studies have shown improved outcomes with steroid use in this subset of patients; however, the use of high doses of steroids predisposes these patients to develop various complications such as opportunistic infections. The incidence of pulmonary cryptococcosis (PC) in patients with post-COVID-19 PF is not known. Here, we discuss a middle-aged male, with no pulmonary comorbidities, who developed PC secondary to the immunocompromised state from high-dose steroid use for the management of post-COVID-19 PF.
ABSTRACT
COVID-19 infection has cardiovascular manifestations such as acute myocarditis, arrhythmia, ischemic cardiomyopathy, heart failure, pericardial effusion, cardiac tamponade, and thromboembolism. The COVID-19 mRNA vaccines BNT162b2 (Pfizer-BioNTech), mRNA-1273 (Moderna), and viral vector vaccine Ad26.COV2.S (Johnson & Johnson - Janssen) were initially approved for emergency authorized use by the US-FDA. Cases of myocarditis were reported primarily in adolescents and young adults after administration of COVID-19 mRNA vaccines, with the subsequent emergence of cases of myocarditis after administration of viral vector vaccine Ad26.COV2.S. A majority of these cases were observed after the second dose of the mRNA vaccine. This case report demonstrates the occurrence of symptomatic myocarditis in a patient during acute COVID-19 infection, followed by recurrence of symptoms after the first dose of mRNA COVID-19 vaccine and subsequent recurrence of cardiac MRI-proven myocarditis after the second dose of mRNA COVID-19 vaccine. This case stands out due to the occurrence of symptoms with COVID-19 infection and after vaccination, suggesting possible incomplete interval resolution of infection-related myocarditis.