High viral loads: what drives fatal cases of COVID-19 in vaccinees? – an autopsy study
Modern Pathology, ISSN: 0893-3952, Vol: 35, Issue: 8, Page: 1013-1021
2022
- 7Citations
- 32Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations7
- Citation Indexes6
- CrossRef4
- Policy Citations1
- Policy Citation1
- Captures32
- Readers32
- 32
Article Description
The rate of SARS-CoV-2 infections in vaccinees has become a relevant serious issue. This study aimed to determine the causes of death, histological organ alteration, and viral spread in relation to demographic, clinical-pathological, viral variants, and vaccine types for deceased individuals with proven SARS-CoV-2 infection after vaccination who died between January and November 2021. Twenty-nine consecutively collected cases were analyzed and compared to 141 nonvaccinated control cases. Autopsies were performed on 16 partially and 13 fully vaccinated individuals. Most patients were elderly and suffered from several relevant comorbidities. Real-time RT-PCR (RT-qPCR) identified a significantly increased rate of generalized viral dissemination within organ systems in vaccinated cases versus nonvaccinated cases (45% vs. 16%, respectively; P = 0.008) mainly with Ct-values of higher than 25 in non-respiratory samples. However, vaccinated cases also showed high viral loads, reaching Ct-values below 10, especially in the upper airways and lungs. This was accompanied by high rates of pulmonal bacterial or mycotic superinfections and the occurrence of immunocompromising factors, such as malignancies, immunosuppressive drug intake, or decreased immunoglobulin levels. All these findings were particularly accentuated in partially vaccinated patients compared to fully vaccinated individuals. The virus dissemination observed in our case study may indicate that patients with an impaired immune system have a decreased ability to eliminate the virus. However, the potential role of antibody-dependent enhancement must also be ruled out in future studies. Fatal cases of COVID-19 in vaccinees were rare and often associated with severe comorbidities or other immunosuppressive conditions.
Bibliographic Details
http://www.sciencedirect.com/science/article/pii/S0893395222000941; http://dx.doi.org/10.1038/s41379-022-01069-9; http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85127544064&origin=inward; http://www.ncbi.nlm.nih.gov/pubmed/35365771; https://linkinghub.elsevier.com/retrieve/pii/S0893395222000941; https://dx.doi.org/10.1038/s41379-022-01069-9
Elsevier BV
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