First case of postmortem study in a patient vaccinated against SARS-CoV-2

Int J Infect Dis. 2021 Jun:107:172-175. doi: 10.1016/j.ijid.2021.04.053. Epub 2021 Apr 16.

Abstract

A previously symptomless 86-year-old man received the first dose of the BNT162b2 mRNA COVID-19 vaccine. He died 4 weeks later from acute renal and respiratory failure. Although he did not present with any COVID-19-specific symptoms, he tested positive for SARS-CoV-2 before he died. Spike protein (S1) antigen-binding showed significant levels for immunoglobulin (Ig) G, while nucleocapsid IgG/IgM was not elicited. Acute bronchopneumonia and tubular failure were assigned as the cause of death at autopsy; however, we did not observe any characteristic morphological features of COVID-19. Postmortem molecular mapping by real-time polymerase chain reaction revealed relevant SARS-CoV-2 cycle threshold values in all organs examined (oropharynx, olfactory mucosa, trachea, lungs, heart, kidney and cerebrum) except for the liver and olfactory bulb. These results might suggest that the first vaccination induces immunogenicity but not sterile immunity.

Keywords: Autopsy; Histology; RT-PCR; SARS-CoV-2; Vaccine.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Antibodies, Viral / blood
  • Autopsy
  • BNT162 Vaccine
  • COVID-19 / prevention & control*
  • COVID-19 Vaccines / immunology*
  • Humans
  • Male
  • SARS-CoV-2 / immunology*
  • Vaccination*

Substances

  • Antibodies, Viral
  • COVID-19 Vaccines
  • BNT162 Vaccine