# Interstitial Lung Disease With Respiratory Failure After COVID-19 mRNA Vaccination

## TL;DR

A woman in her 70s developed lung disease requiring oxygen after her fifth COVID-19 mRNA vaccine dose, showing a rare and persistent reaction.

## Contribution

This case highlights a rare post-vaccination interstitial lung disease with unique clinical features and resistance to corticosteroid treatment.

## Key findings

- A chest X-ray showed bilateral diffuse ground-glass opacities after the fifth vaccination.
- Lung biopsy revealed alveolar epithelium growth and polypoid granulation tissues.
- Corticosteroids were ineffective, leading to persistent fibrosis and long-term oxygen therapy.

## Abstract

A septuagenarian woman developed dyspnea on the day following a fifth vaccination. Just before vaccination, a chest X-ray showed no abnormalities, but after the fifth vaccination, bilateral diffuse ground-glass opacities were detected. Bronchoalveolar lavage revealed a lymphocyte predominance and transbronchial lung biopsy revealed growth of the alveolar epithelium, along with organized polypoid granulation tissues in the alveolar ducts and bronchioles. Despite the administration of corticosteroids, imaging revealed persistent fibrosis, and she required long-term oxygen therapy. Although recent reports indicated that corticosteroids are effective for drug-induced interstitial lung disease related to COVID-19 mRNA vaccination, this case presented a somewhat different clinical manifestation.