이상반응 보고
VAERS ID | 1169796 |
---|---|
성별 | 여성 |
나이 | 81세 |
주 코드 | NY |
제약회사 | MODERNA |
로트 번호 | 039K20A |
예방접종 횟수 | 1 |
접종일 | 2021-02-07 |
발병일 | 2021-02-21 |
상태 | 입원 중증 사망 |
증상
- 피로(Fatigue)
- 발열(Pyrexia)
- 설사(Diarrhoea)
- 호흡곤란(Dyspnoea)
- 흉부 엑스레이 이상(Chest X-ray abnormal)
- SARS-CoV-2 테스트 음성(SARS-CoV-2 test negative)
- C 반응성 단백질 증가(C-reactive protein increased)
- 항핵항체 양성(Antinuclear antibody positive)
- 결절(Nodule)
- 컴퓨터 단층 촬영 비정상(Computerised tomogram abnormal)
- SARS-CoV-2 항체 검사(SARS-CoV-2 antibody test)
- 백혈구 수 증가(White blood cell count increased)
- 호흡기 세포융합 바이러스 검사 음성(Respiratory syncytial virus test negative)
- 인플루엔자 바이러스 검사 음성(Influenza virus test negative)
- 혈액 배양 음성(Blood culture negative)
- 호중구 수 증가(Neutrophil count increased)
- 기관 삽관(Endotracheal intubation)
- 죽음(Death)
- 저산소증(Hypoxia)
- 폐 불투명도(Lung opacity)
- 세균 검사 양성(Bacterial test positive)
- 혈중 젖산 탈수소효소 증가(Blood lactate dehydrogenase increased)
- 폐 침윤(Lung infiltration)
- HIV 검사 음성(HIV test negative)
- 간질성 폐질환(Interstitial lung disease)
- 레지오넬라 검사(Legionella test)
- 적혈구 수 증가(Red blood cell count increased)
- 프로칼시토닌 정상(Procalcitonin normal)
- 곰팡이 검사 음성(Fungal test negative)
- 기관지확장증(Bronchiectasis)
- 기관지경(Bronchoscopy)
- 마이코박테리움 검사 음성(Mycobacterium test negative)
- 급성 간질성 폐렴(Acute interstitial pneumonitis)
이환 중 질병
None
지병
Denied
기타 의료
이전 예방접종
알레르기
NKDA
임상 검사
- CT (3/3): moderate bilateral, predominantly dependent and peripheral/subpleural reticular and irregular groundglass and consolidative opacities, some with slightly rounded/nodular morphology; mild traction bronchiectasis; no pleural effusion or pneumothorax.
- s/p bronchoscopy (3/9): BAL in lingula, 180 mL in / 90 mL out; mucous plugs present in return fluid.
Labs/micro: - SARS/flu/RSV/BioFire neg, Legionella UAg neg, Bcxs neg - procalcitonin 0.
05 (2/28) > 0.
09 (3/8) 2/28 SARS-CoV-2 semi-quantitative IgG (Kantaro assay) 4,447 AU/mL [ref range, < 5 AU/mL = negative to >40 AU/mL = Strong positive "Interpretation: The Semi-Quantitative SARS-COV-2 IgG results of >40 AU/mL confirm the presence of circulating IgG antibodies specific for SARS-CoV-2 at high levels.
Corresponding serum titers range from 960 and rise to above 2880 with increasing numerical value.
"] - 3/5 ANA 1:320, homogenous - 3/5 CRP 35 >> 150; LDH 830 - 3/9 BAL RBC 1.
95K, WBC 473/68% polys, 26% macs, bacteria seen.
SARS PCR neg.
GS 1-9 polys, no orgs, cx usu resp flora, fungal cx neg, - AFB neg x6 - HIV neg; no known immunosuppressive predisposition to OIs like PCP or other fungi; serum CrAg/GM/Fungitell neg and sputum PCP DFA neg
증상 상세
4/2020 presumed COVID-19 (not formally diagnosed, not hospitalized) 2/07/21 Moderna vaccine #1 (date per pt's daughter) 2/21/21 onset SOB/DOE, fever 2/24/21 Seen at Urgent Care: RML crackles and infiltrate on CXR, given azithromycin and Augmentin 2/27/21 Presented to ED with progression of SOB/DOE, fatigue, diarrhea.
Hypoxemic requiring low-flow NC, B/L basilar crackles noted; started on CTX/azithro (2/27-3/3) for presumed CAP 3/08/21 Required HFNC; first seen by me personally: diffuse, distinct velcro crackles, lower > upper fields 3/12/21 Started on high-dose steroids without improvement; unable to wean from HFNC with progressively worsening hypoxemia; pt declined intubation.
03/22/21 Patient died in Palliative Care Unit Diagnosis: Interstitial lung disease of uncertain etiology, acute interstitial pneumonitis vs.
undiagnosed connective tissue disease