Volume 28, Number 5—May 2022
Dispatch
Severe Multisystem Inflammatory Symptoms in 2 Adults after Short Interval between COVID-19 and Subsequent Vaccination
Elizabeth R. Jenny-Avital
and Ruth A. Howe1
and Ruth A. Howe1
Table
Characteristics of 5 previously published MIS cases occurring after COVID-19 vaccine was administered within 1 month of infection, United States*
| Case no. and search term | VAERS ID | Patient age, y/sex | COVID-19 date | Vaccine date, type† | Description in VAERS | Treatment and outcome |
|---|---|---|---|---|---|---|
| 1. MIS | 1396536 | 53/F | 2021 May 7 | 2021 May 29, Pfizer-BioNTech | 2021 May 31: febrile (101.3°F), initial GI symptoms, dyspnea; admitted June 1; hypotensive (63/48 mm Hg) requiring vasopressors; leukocytes 31.3 × 103 cells/µL, creatinine 4.6 mg/dL, bilirubin 5.5 mg/dL, EF 35% | Immunoglobulin infusion for prolonged hypotension despite antibiotics; weaned from vasopressors, reduced EF, and renal failure resolved |
| 2. MIS | 1282200 | 40/M | 2020 Dec 26 | 2021 Jan 25, Pfizer-BioNTech | 2021 Jan 29: fever, headache, neck pain, weakness, fatigue, diarrhea, abdominal pain; admitted after 2 emergency department visits with elevated cardiac inflammatory markers (BNP and troponin) | Steroids, with complete resolution |
| 3. MIS | 1154625 | 48/F | 2021 Dec 31 | 2021 Jan 22, Moderna | 2021 Feb 1: MIS with GI symptoms, rash, conjunctival injection, encephalopathy, elevated BNP | Immunoglobulin infusion, steroids, aspirin, with good response |
| 4. Acute heart failure and fever | 1027010 | 45/M | 2020 Dec 30 | 2021 Jan 22, Pfizer-BioNTech | 2021 Jan 30: fever, hypotension, morbilliform rash, cariogenic shock, EF 35%, CRP >320, BNP 3,583, SARS-CoV-2 antibody-positive | Intra-aortic balloon pump, antibiotics; resolution, with EF 67% |
| 5. Myocarditis and fever | 1088210, 1122743 | 46/F | 2021 early Jan | 2021 Feb 5‡ | 2021 Feb 23: 5 d fever, sore throat, swelling in hands/feet, EF 35%, hypotension requiring vasopressor, CRP >300 mg/L, ferritin 3,054 mcg/L, severe thrombocytopenia | Antibiotics, steroids, mechanical ventilation, ECMO, intra-aortic balloon pump support |
*BNP, brain natriuretic peptide; COVID-19, coronavirus disease; CRP, C-reactive protein; ECMO, extracorporeal membrane oxygenation; EF, ejection fraction; FU, follow-up; GI, gastrointestinal; ID, identification; MIS, multisystem inflammatory syndrome; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; VAERS, Vaccine Adverse Event Reporting System. †Pfizer-BioNTech, https://www.pfizer.com; Moderna, https://www.moderna.com. ‡Vaccine type not available in VAERS report.
1Current affiliation: University of Washington, Seattle, Washington, USA.
Page created: March 01, 2022
Page updated: April 19, 2022
Page reviewed: April 19, 2022
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