Accelerated Extensive Lung Fibrosis Post–COVID-19 Immunization in an Asthmatic Patient

Wafaa Alshahrani, Nadia M. Samad, Muhammad Rehan Malik, Abdullah Abdulwahed Eid
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Abstract

We describe a unique case of a 60-year-old asthmatic Saudi patient who developed acute respiratory distress syndrome (ARDS) and accelerated lung fibrosis after the administration of the second dose of the COVID-19 mRNA vaccine. This patient presented to the emergency room with a four-day history of fever, shortness of breath, and cough. His hospitalization was complicated by non-ST segment elevation myocardial infarction, non-sustained ventricular tachycardia, and a lowered Glasgow Coma Scale. He was intubated at a P/F ratio of 73 mmHg and a peak inspiratory pressure of 46 cmH2O. His antibiotics had to be modified, as he had QT prolongation. Additional anti-pseudomonal, anti-anaerobe, and anti-fungal coverings were empirically given, which were later switched to colistin based on the results of a sputum culture. On ICU day 17, the patient went into cardiac arrest due to severe ARDS and septic shock. Despite attempts at resuscitation, he was unable to be revived.
一名哮喘患者在接受 COVID-19 免疫接种后加速了大面积肺纤维化
我们描述了一例独特的病例:一名 60 岁的沙特哮喘患者在接种第二剂 COVID-19 mRNA 疫苗后出现急性呼吸窘迫综合征(ARDS)并加速肺纤维化。该患者因发热、呼吸急促和咳嗽四天前往急诊室就诊。非ST段抬高型心肌梗死、非持续性室性心动过速和格拉斯哥昏迷量表降低使他的住院治疗变得复杂。他插管时的血压/心跳比为 73 mmHg,吸气压力峰值为 46 cmH2O。由于他出现了 QT 间期延长,因此必须对抗生素进行调整。根据痰培养结果,他又服用了抗假丝酵母、抗花生酵母和抗真菌药物,后来又改用了可乐定。在重症监护室的第 17 天,患者因严重的急性呼吸衰竭和脓毒性休克而心跳骤停。尽管尝试了各种抢救措施,但他还是无法苏醒。
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