Table 1.
Characteristics of the three patients at presentation and clinical outcomes.
| Patient 1 | Patient 2 | Patient 3 | |
|---|---|---|---|
| Age/Gender | 66/Male | 85/Male | 62/Male |
| Smoking status | Ex-smoker | Ex-smoker | Non-smoker |
| Underlying ILD | Yes (DIP) | Yes (unknown) | No |
| Onset since given vaccine | 1 day after first vaccination | 3–5 days after first vaccination | 2 days after second vaccination |
| Symptoms | Fever, fatigue | Dyspnea | Fever |
| RT-PCR test for SARS-CoV-2 nucleic acid | Negative | Negative | Negative |
| Autoantibodies for CVD | Negative | Negative | MPO-ANCA (+) |
| Serological tests | |||
| KL-6, U/mL (normal range <500 U/mL) | 1306 | 4084 | 297 |
| SP-D, ng/mL (normal range <110 ng/mL) | 376.4 | 675.5 | 189.0 |
| BAL findings | |||
| Macrophages, % | 55 | 30.7 | – |
| Lymphocytes, % | 42.3 | 62.7 | – |
| Neutrophils, % | 1.7 | 0 | – |
| Eosinophils, % | 1 | 6.7 | – |
| CD4/CD8 | 1.3 | 6.6 | – |
| Treatment for pneumonitis | None | Methylprednisolone, predonisolone | Predonisolone |
| Serological tests 3 months after the onset | |||
| KL-6, U/mL (normal range <500 U/mL) | 529 | 1550 | – |
| SP-D, ng/mL (normal range <110 ng/mL) | 163.3 | 200.3 | – |
| Outcome | Improved | Improved | Improved |
DIP, desquamative interstitial pneumonia; RT-PCR, real-time fluorescence polymerase chain reaction; SARS-CoV-2, severe acute respiratory syndrome-Coronavirus-2; CVD, collagen vascular disease; MPO-ANCA, myeloperoxidase-anti-neutrophil cytoplasmic antibody; KL-6, Krebs von den Lungen 6; SP-D, surfactant protein D; BAL, bronchoalveolar lavage