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Abstract: PO0150

COVID-19 Vaccine and Multiple Viral Infection: Cross-Reaction?

Session Information

Category: Coronavirus (COVID-19)

  • 000 Coronavirus (COVID-19)

Authors

  • Rivera Sepulveda, Jose, Mayaguez Medical Center, Mayaguez, Puerto Rico
  • Pabon-Vazquez, Elizabeth, Mayaguez Medical Center, Mayaguez, Puerto Rico
Introduction

The COVID-19 pandemic has brought a lot of challenges in the medical and educational field.Every day, new facts and knowledge are published about the pathophysiology, treatment, and prognosis of COVID-19 patients.In addition, community response to vaccination and vaccine side effects has been one of the major talking points in social media.The general public wants to fully understand if the vaccine really provides immunity and possible side effects of its use.

Case Description

Under this premise, a 36 y/o female patient with a past medical history of type 2 diabetes mellitus, hypertension and obesity came to emergency department 2 days after she received the second dose of Moderna COVID-19 vaccine, and developed non-quantified fever, general malaise, vomiting and watery diarrhea.Associated symptoms were scattered non-blanching maculopapular rash from head to shoulders to mid back and abdomen, pustules inside ear and decrease urine output.Patient was unable to urinate for at least 48hrs. Laboratory bloodwork was remarkable for hyponatremia, hypochloremia, high anion gap metabolic acidosis and creatinine clearance of 18ml/min.Hepatic enzymes were more than five times elevated, and total bilirubin was elevated as well.Urinalysis reported proteinuria, positive leukocytes esterase, few calcium oxalate crystals and many urate amorphous sediment.Patient was convinced that symptoms were related to COVID-19 vaccination.Etiology of symptoms remained unclear at admission, for that reason she was admitted and received isotonic IV fluids.Further laboratory bloodwork reported elevated LDH, creatinine kinase and hypertriglyceridemia.In addition, infectious disease workup was performed, in which HAV, VZV, EBV, CMV IgM were positive. Patient received inpatient supportive care for five days. Renal function normalized, rash improve and the patient was discharged home with close follow up.

Discussion

There are different reasons that could explain patient’s acute kidney injury.From dehydration to sepsis is the spectrum of differential diagnosis in this patient.The renal function recovery after hydration, clearly suggest pre-renal injury.Viral infection could be the primary reason of her dehydration.However, the event of vaccination, could not be completely ruled out.Was the vaccine a catalyst for viral infection?Or was the vaccine a confounder in this patient’s renal failure?