COVID-19 Vaccine-Associated Pneumonitis in the Republic of Korea: A Nationwide Multicenter Survey

Hongseok Yoo; Song Yee Kim; Moo Suk Park; Sung Hwan Jeong; Sung Woo Park; Hong Lyeol Lee; Hyun Kyung Lee; Sei Hoon Yang; Yangjin Jegal; Jung Wan Yoo; Jongmin Lee; Hyung Koo Kang; Sun Mi Choi; Jimyung Park; Young Whan Kim; Jin Woo Song; Joo Hun Park; Won Il Choi; Hye Sook Choi; Chul Park; Jeong Woong Park; Man Pyo Chung

doi:10.3346/jkms.2023.38.e106

COVID-19 Vaccine-Associated Pneumonitis in the Republic of Korea: A Nationwide Multicenter Survey

Hongseok Yoo, Song Yee Kim, Moo Suk Park, Sung Hwan Jeong, Sung Woo Park, Hong Lyeol Lee, Hyun Kyung Lee, Sei Hoon Yang, Yangjin Jegal, Jung Wan Yoo, Jongmin Lee, Hyung Koo Kang, Sun Mi Choi, Jimyung Park, Young Whan Kim, Jin Woo Song, Joo Hun Park, Won Il Choi, Hye Sook Choi, Chul ParkJeong Woong Park, Man Pyo Chung

Division of Pulmonology

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

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.

Original language	English
Article number	e106
Journal	Journal of Korean Medical Science
Volume	38
Issue number	14
DOIs	https://doi.org/10.3346/jkms.2023.38.e106
State	Published - 2023

Bibliographical note

Publisher Copyright:
© 2023 The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords

COVID-19
Interstitial Lung Disease
Pneumonitis
SARS-CoV-2
Vaccine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3346/jkms.2023.38.e106

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Yoo, H., Kim, S. Y., Park, M. S., Jeong, S. H., Park, S. W., Lee, H. L., Lee, H. K., Yang, S. H., Jegal, Y., Yoo, J. W., Lee, J., Kang, H. K., Choi, S. M., Park, J., Kim, Y. W., Song, J. W., Park, J. H., Choi, W. I., Choi, H. S., ... Chung, M. P. (2023). COVID-19 Vaccine-Associated Pneumonitis in the Republic of Korea: A Nationwide Multicenter Survey. Journal of Korean Medical Science, 38(14), Article e106. https://doi.org/10.3346/jkms.2023.38.e106

@article{50ed5a74f197472c84bea69279431669,

title = "COVID-19 Vaccine-Associated Pneumonitis in the Republic of Korea: A Nationwide Multicenter Survey",

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.",

keywords = "COVID-19, Interstitial Lung Disease, Pneumonitis, SARS-CoV-2, Vaccine",

author = "Hongseok Yoo and Kim, {Song Yee} and Park, {Moo Suk} and Jeong, {Sung Hwan} and Park, {Sung Woo} and Lee, {Hong Lyeol} and Lee, {Hyun Kyung} and Yang, {Sei Hoon} and Yangjin Jegal and Yoo, {Jung Wan} and Jongmin Lee and Kang, {Hyung Koo} and Choi, {Sun Mi} and Jimyung Park and Kim, {Young Whan} and Song, {Jin Woo} and Park, {Joo Hun} and Choi, {Won Il} and Choi, {Hye Sook} and Chul Park and Park, {Jeong Woong} and Chung, {Man Pyo}",

note = "Publisher Copyright: {\textcopyright} 2023 The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.",

year = "2023",

doi = "10.3346/jkms.2023.38.e106",

language = "English",

volume = "38",

journal = "Journal of Korean Medical Science",

issn = "1011-8934",

publisher = "Korean Academy of Medical Science",

number = "14",

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Yoo, H, Kim, SY, Park, MS, Jeong, SH, Park, SW, Lee, HL, Lee, HK, Yang, SH, Jegal, Y, Yoo, JW, Lee, J, Kang, HK, Choi, SM, Park, J, Kim, YW, Song, JW, Park, JH, Choi, WI, Choi, HS, Park, C, Park, JW & Chung, MP 2023, 'COVID-19 Vaccine-Associated Pneumonitis in the Republic of Korea: A Nationwide Multicenter Survey', Journal of Korean Medical Science, vol. 38, no. 14, e106. https://doi.org/10.3346/jkms.2023.38.e106

TY - JOUR

T1 - COVID-19 Vaccine-Associated Pneumonitis in the Republic of Korea

T2 - A Nationwide Multicenter Survey

AU - Yoo, Hongseok

AU - Kim, Song Yee

AU - Park, Moo Suk

AU - Jeong, Sung Hwan

AU - Park, Sung Woo

AU - Lee, Hong Lyeol

AU - Lee, Hyun Kyung

AU - Yang, Sei Hoon

AU - Jegal, Yangjin

AU - Yoo, Jung Wan

AU - Lee, Jongmin

AU - Kang, Hyung Koo

AU - Choi, Sun Mi

AU - Park, Jimyung

AU - Kim, Young Whan

AU - Song, Jin Woo

AU - Park, Joo Hun

AU - Choi, Won Il

AU - Choi, Hye Sook

AU - Park, Chul

AU - Park, Jeong Woong

AU - Chung, Man Pyo

N1 - Publisher Copyright: © 2023 The Korean Academy of Medical Sciences. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

PY - 2023

Y1 - 2023

N2 - 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.

AB - 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.

KW - COVID-19

KW - Interstitial Lung Disease

KW - Pneumonitis

KW - SARS-CoV-2

KW - Vaccine

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U2 - 10.3346/jkms.2023.38.e106

DO - 10.3346/jkms.2023.38.e106

M3 - Article

C2 - 37038643

AN - SCOPUS:85152109998

SN - 1011-8934

VL - 38

JO - Journal of Korean Medical Science

JF - Journal of Korean Medical Science

IS - 14

M1 - e106

ER -

COVID-19 Vaccine-Associated Pneumonitis in the Republic of Korea: A Nationwide Multicenter Survey

Abstract

Bibliographical note

Keywords

UN SDGs

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