Patients With Suspected Severe Adverse Reactions to COVID-19 Vaccination Admitted to Intensive Care Unit: A Case Report

Denise Battaglini; Lorenzo Ball; Chiara Robba; Simona Maiani; Iole Brunetti; Luana Benedetti; Lucio Castellan; Gianluigi Zona; Giampaola Pesce; Patricia R M Rocco; Paolo Pelosi

doi:10.3389/fmed.2022.823837

Patients With Suspected Severe Adverse Reactions to COVID-19 Vaccination Admitted to Intensive Care Unit: A Case Report

Front Med (Lausanne). 2022 Mar 18:9:823837. doi: 10.3389/fmed.2022.823837. eCollection 2022.

Authors

Denise Battaglini^{1

2}, Lorenzo Ball^{1

3}, Chiara Robba^{1

3}, Simona Maiani¹, Iole Brunetti¹, Luana Benedetti^{4

5}, Lucio Castellan⁶, Gianluigi Zona^{4

7}, Giampaola Pesce^{8

9}, Patricia R M Rocco¹⁰, Paolo Pelosi^{1

3}

Affiliations

¹ Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.
² Department of Medicine, University of Barcelona, Barcelona, Spain.
³ Department of Surgical Science and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy.
⁴ Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Children (DINOGMI), University of Genoa, Genoa, Italy.
⁵ UO Clinica Neurologica, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.
⁶ Department of Radiology and Neuroradiology, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.
⁷ Department of Neurosurgery, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy.
⁸ UOSD Laboratorio Diagnostico di Autoimmunologia, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
⁹ Dipartimento di Medicina Interna e Specialità Mediche (DiMI), Università di Genova, Genoa, Italy.
¹⁰ Laboratory of Pulmonary Investigation, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.

Abstract

Background: Several cases of adverse reactions following vaccination for coronavirus disease 2019 (COVID-19) with adenoviral vector vaccines or mRNA-based vaccines have been reported to date. The underlying syndrome has been named "vaccine-induced immune thrombotic thrombocytopenia" (VITT) or "thrombosis with thrombocytopenia syndrome (TTS)" with different clinical manifestations.

Methods: We report the clinical course of five patients who had severe adverse reactions to COVID-19 vaccines, either with VITT/TTS, abdominal or pulmonary thrombosis after adenoviral vaccines, or Stevens' Johnson syndrome because of mRNA vaccination, all of whom required admission to the intensive care unit (ICU).

Conclusions: All patients with severe or life-threatening suspected reaction to different types of COVID-19 vaccination required ICU admission. A prompt evaluation of early symptoms and individualized clinical management is needed to improve outcomes.

Keywords: COVID-19; coronavirus disease 2019; thrombosis with thrombocytopenia syndrome; vaccine-induced immune thrombotic thrombocytopenia; vaccines.

Publication types

Case Reports