Acute Eosinophilic Pneumonia Associated With the Anti-COVID-19 Vaccine AZD1222

Abstract

SARS-CoV-2 is an emerging virus causing the contemporary global pandemic. No cure has yet been discovered. Therefore, vaccination remains the only hope. We report the case of a 66-year-old male patient with a history of allergies. Five hours after his vaccination with the anti-COVID-19 vaccine AZD1222 (ChAdOx1 nCoV-19, AstraZeneca), he developed acute respiratory distress. The biological assessment showed hyperleukocytosis, 20% of which are eosinophils. Diagnosis of severe postvaccination acute eosinophilic pneumonia was retained given the history of allergy, lack of improvement on antibiotics, elimination of all other probable causes of eosinophilia, and improvement on corticosteroids. Such reactions of eosinophilic pneumonia have only been described twice: once following vaccination with the influenza vaccine (Vaxigrip*) and the other after vaccination with the 23-valent pneumococcal polysaccharide vaccine (Pneumovax 23*). Hypereosinophilia must be taken into consideration, feared, and prevented. Although rare and severe, post-COVID-19 vaccination acute eosinophilic pneumonia remains well manageable with corticosteroids with a good outcome. Therefore, in some poorly monitored patients with allergy or asthma, the use of another less allergenic vaccine could be considered to avoid such reactions.