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COVID-19 Vaccine-Associated Pneumonitis in the Republic of Korea: A Nationwide Multicenter Survey.
Yoo, Hongseok; Kim, Song Yee; Park, Moo Suk; Jeong, Sung Hwan; Park, Sung-Woo; Lee, Hong Lyeol; Lee, Hyun-Kyung; Yang, Sei-Hoon; Jegal, Yangjin; Yoo, Jung-Wan; Lee, Jongmin; Kang, Hyung Koo; Choi, Sun Mi; Park, Jimyung; Kim, Young Whan; Song, Jin Woo; Park, Joo Hun; Choi, Won-Il; Choi, Hye Sook; Park, Chul; Park, Jeong-Woong; Chung, Man Pyo.
  • Yoo H; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • Kim SY; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Park MS; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • Jeong SH; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
  • Park SW; Division of Allergy and Respiratory Medicine, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
  • Lee HL; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, Inha University, Incheon, Korea.
  • Lee HK; Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Busan Paik Hospital, Inje University, Busan, Korea.
  • Yang SH; Division of Pulmonary, Department of Internal Medicine, College of Medicine, Wonkwang University, Iksan, Korea.
  • Jegal Y; Division of Pulmonary and Critical Medicine, Department of Internal Medicine, Ulsan University Hospital, College of Medicine, University of Ulsan, Ulsan, Korea.
  • Yoo JW; Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea.
  • Lee J; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • Kang HK; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea.
  • Choi SM; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea.
  • Park J; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea.
  • Kim YW; Division of Respiratory-Allergy and Clinical Immunology, Department of Internal Medicine, Konkuk University Medical Center, Seoul, Korea.
  • Song JW; Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • Park JH; Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea.
  • Choi WI; Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
  • Choi HS; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Kyunghee University Hospital, Seoul, Korea.
  • Park C; Division of Pulmonary, Department of Internal Medicine, College of Medicine, Wonkwang University, Iksan, Korea.
  • Park JW; Division of Allergy, Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
  • Chung MP; Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. mpchung@skku.edu.
J Korean Med Sci ; 38(14): e106, 2023 Apr 10.
Article in English | MEDLINE | ID: covidwho-2306186
ABSTRACT

BACKGROUND:

Recent reports have suggested that pneumonitis is a rare complication following vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, its clinical features and outcomes are not well known. The aim of this study was to identify the clinical characteristics and outcomes of patients with vaccine-associated pneumonitis following vaccination against SARS-CoV-2.

METHODS:

In this nationwide multicenter survey study, questionnaires were distributed to pulmonary physicians in referral hospitals. They were asked to report cases of development or exacerbation of interstitial lung disease (ILD) associated with the coronavirus disease 2019 vaccine. Vaccine-associated pneumonitis was defined as new pulmonary infiltrates documented on chest computed tomography within 4 weeks of vaccination and exclusion of other possible etiologies.

RESULTS:

From the survey, 49 cases of vaccine-associated pneumonitis were identified between February 27 and October 30, 2021. After multidisciplinary discussion, 46 cases were analyzed. The median age was 66 years and 28 (61%) were male. The median interval between vaccination and respiratory symptoms was 5 days. There were 20 (43%), 17 (37%), and nine (19%) patients with newly identified pneumonitis, exacerbation of pre-diagnosed ILD, and undetermined pre-existing ILD, respectively. The administered vaccines were BNT162b2 and ChAdOx1 nCov-19/AZD1222 each in 21 patients followed by mRNA-1273 in three, and Ad26.COV2.S in one patient. Except for five patients with mild disease, 41 (89%) patients were treated with corticosteroid. Significant improvement was observed in 26 (57%) patients including four patients who did not receive treatment. However, ILD aggravated in 9 (20%) patients despite treatment. Mortality was observed in eight (17%) patients.

CONCLUSION:

These results suggest pneumonitis as a potentially significant safety concern for vaccines against SARS-CoV-2. Clinical awareness and patient education are necessary for early recognition and prompt management. Additional research is warranted to identify the epidemiology and characterize the pathophysiology of vaccine-associated pneumonitis.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / COVID-19 Vaccines / COVID-19 Type of study: Etiology study / Observational study / Prognostic study Topics: Vaccines Limits: Aged / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: J Korean Med Sci Journal subject: Medicine Year: 2023 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia / COVID-19 Vaccines / COVID-19 Type of study: Etiology study / Observational study / Prognostic study Topics: Vaccines Limits: Aged / Female / Humans / Male Country/Region as subject: Asia Language: English Journal: J Korean Med Sci Journal subject: Medicine Year: 2023 Document Type: Article