ORGANIZING PNEUMONIA AS A SIDE EFFECT OF COVID-19 VACCINE

Abstract

TYPE: Case Report TOPIC: Diffuse Lung Disease INTRODUCTION: Comprehensive side effects of Coronavirus disease 2019 (COVID-19) vaccine are still unknown. Here we report the case of organizing pneumonia (OP) post COVID-19 vaccination. CASE PRESENTATION: A 73-year-old male with past medical history of hypertension presents with shortness of breath, cough, low-grade fever, generalized weakness and decreased appetite for one week. Patient had received second dose of COVID-19 vaccination 2 months prior. Physical examination revealed bilateral crepitations. Patient was hypoxic requiring supplemental oxygen. COVID-19 PCR and rapid antigen test (x 2) were negative. Computed tomography showed extensive bilateral ground glass infiltrates and some interstitial septal thickening with nodular infiltrates. Patient was started on broad spectrum antibiotics. Multiple transbronchial biopsies collected from different sites showed findings consistent with typical organizing pneumonia. Further infectious, immunologic, rheumatologic and vasculitis work-up to look for underlying cause of OP was negative. DISCUSSION: OP is a histopathological condition in which bronchioles, alveoli and walls of small bronchi become inflamed and get occupied with buds of granulation tissue progressing from fibrin exudates to loose collagen containing fibroblasts. It has varied radiologic manifestations. In addition to cryptogenic organizing pneumonia, it can be seen in vasculitis, bronchocentric granulomatosis, chronic eosinophilic pneumonia, hypersensitivity pneumonia, diffuse alveolar damage, non-specific pneumonia, lung abscess, pulmonary infarct and cancers. Secondary OP can be caused secondary to heart-lung transplantation, bone-marrow transplantation, infections, acute respiratory distress syndrome, drug use, radiotherapy, connective tissue diseases and aspiration pneumonia. CONCLUSIONS: As this being the first reported case of post COVID-19 vaccine related OP, further studies and data is required to establish causative relationship. DISCLOSURE: Nothing to declare. KEYWORD: Coronavirus disease 2019 vaccine