An Acute Exacerbation of Idiopathic Pulmonary Fibrosis After BNT162b2 mRNA COVID-19 Vaccination: A Case Report

Chest. 2022 Feb;161(2):e71-e73. doi: 10.1016/j.chest.2021.07.2160.

Abstract

Idiopathic pulmonary fibrosis (IPF) is a fatal interstitial lung disease characterized by progressive scar tissue formation. An acute exacerbation of IPF (AE-IPF) is a clinically significant respiratory decompensation that accounts for a significant proportion of IPF-related morbidity and mortality. AE-IPF can be idiopathic or associated with pulmonary embolism, infection, aspiration, surgery, and drug toxicity. In this novel case report, we describe a potential association between AE-IPF and BNT162b2 mRNA COVID-19 vaccination that was successfully treated with a short course of glucocorticoids. While our aim is to raise awareness for this yet-to-be-described adverse event, immunization against vaccine-preventable disease remains widely recommended in vulnerable patients with chronic lung disease such as IPF.

Keywords: BNT162b2 mRNA COVID-19 vaccine; COVID-19; acute exacerbation; idiopathic pulmonary fibrosis; interstitial lung disease.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • BNT162 Vaccine* / administration & dosage
  • BNT162 Vaccine* / adverse effects
  • COVID-19 / prevention & control*
  • COVID-19 Vaccines / administration & dosage
  • COVID-19 Vaccines / adverse effects
  • Disease Progression
  • Drug Tapering / methods
  • Glucocorticoids / administration & dosage
  • Humans
  • Idiopathic Pulmonary Fibrosis* / diagnosis
  • Idiopathic Pulmonary Fibrosis* / physiopathology
  • Idiopathic Pulmonary Fibrosis* / therapy
  • Lung / diagnostic imaging*
  • Male
  • Methylprednisolone / administration & dosage*
  • Respiratory Insufficiency* / diagnosis
  • Respiratory Insufficiency* / drug therapy
  • Respiratory Insufficiency* / etiology
  • Risk Assessment / methods
  • SARS-CoV-2
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • BNT162 Vaccine
  • COVID-19 Vaccines
  • Glucocorticoids
  • Methylprednisolone