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From the 11/26/2021 release of VAERS data:

Found 78 cases where Age is 18-or-more-and-under-30 and Vaccine targets COVID-19 (COVID19) and Manufacturer is MODERNA and Patient Died

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Case Details

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VAERS ID: 1511613 (history)  
Form: Version 2.0  
Age: 24.0  
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-07-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Asthenia, Dyspnoea, Hypokinesia, Lung disorder, Neuromyelitis optica spectrum disorder
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Optic nerve disorders (narrow), Cardiomyopathy (broad), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-08
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20212

Write-up: weakness; difficulty breathing; unable to move his legs; Lung problem; neuromyletis optica; This spontaneous case was reported by a consumer and describes the occurrence of NEUROMYELITIS OPTICA SPECTRUM DISORDER (neuromyletis optica), ASTHENIA (weakness), DYSPNOEA (difficulty breathing), HYPOKINESIA (unable to move his legs) and LUNG DISORDER (Lung problem) in a 24-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient experienced NEUROMYELITIS OPTICA SPECTRUM DISORDER (neuromyletis optica) (seriousness criteria death, hospitalization and medically significant), ASTHENIA (weakness) (seriousness criteria death and hospitalization), DYSPNOEA (difficulty breathing) (seriousness criteria death and hospitalization), HYPOKINESIA (unable to move his legs) (seriousness criteria death and hospitalization) and LUNG DISORDER (Lung problem) (seriousness criteria death and hospitalization). The patient was hospitalized on 09-Jun-2021 due to ASTHENIA, DYSPNOEA, HYPOKINESIA, LUNG DISORDER and NEUROMYELITIS OPTICA SPECTRUM DISORDER. The patient died on 08-Jul-2021. The reported cause of death was Neuromyelitis optica. It is unknown if an autopsy was performed. No concomitant medication was reported. The patient was placed on ventilator and had a tracheotomy tube. No treatment information was provided. No laboratory data was provided. Very limited information regarding the events has been provided at this time. Reporter did not allow further contact; Sender''s Comments: Very limited information regarding the events has been provided at this time.; Reported Cause(s) of Death: Neuromyelitis optica


VAERS ID: 1535195 (history)  
Form: Version 2.0  
Age: 29.0  
Sex: Male  
Location: New York  
Vaccinated:2021-06-10
Onset:2021-06-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK UN / -

Administered by: Other       Purchased by: ?
Symptoms: Abdominal discomfort, Death, Influenza like illness
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-13
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: diabetes insipidus
Allergies: Tree nuts
Diagnostic Lab Data: Examined by the Office of the Chief Medical Examiner on June 15, 2021.
CDC Split Type:

Write-up: Patient experienced flu-like symptoms and an upset stomach and died 60-72 hours later. Immediate cause of death is still pending further study.


VAERS ID: 1574026 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Louisiana  
Vaccinated:2021-07-24
Onset:2021-07-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002C21A / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, Platelet count decreased, Thrombotic thrombocytopenic purpura
SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Embolic and thrombotic events, arterial (narrow), Renovascular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-14
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Albuterol, apixiban, furosemids, gabapentin, leuprolide, pantoprazole, ondansetron, prednisone, spironalactone, tadalafil, treprostinil.
Current Illness: Pulmonary hypertension, scleroderma, myopathy, nicm, fsgs.
Preexisting Conditions: Pulmonary hypertension, scleroderma, myopathy, nicm, fsgs.
Allergies: Latex
Diagnostic Lab Data: Platelet count went from 277 to 16K/ul
CDC Split Type:

Write-up: Pt developed acute TTP ~3 weeks post dose and subsequently passed away.


VAERS ID: 1582987 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-07-21
Onset:2021-08-01
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 040C21A / 1 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arteriovenous malformation, Cardioversion, Cerebral haemorrhage, Computerised tomogram head abnormal, Cyanosis, Death, Headache, Mechanical ventilation, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Congenital, familial and genetic disorders (narrow), Acute central respiratory depression (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-03
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: Common cold, recovered.
Preexisting Conditions: No
Allergies: No
Diagnostic Lab Data: CT Scan showing brain hemorrhage
CDC Split Type:

Write-up: Young, healthy 25 year old male. Very physically active, no health issues. Suddenly had horrible headache at 2am. Threw up, went to take a shower, girlfriend found him 10-20 min later purple in the shower. Called EMS. Heart & lungs brought back with defibrillator & ventilator. CT scan showed massive brain hemorrhage. No brain activity. Pronounced dead Tuesday Aug 3rd. Doctors concluded ruptured AVM due to amount of blood in brain. Does vaccine cause inflammation that could have caused early rupture?


VAERS ID: 1586936 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Male  
Location: Louisiana  
Vaccinated:2021-08-18
Onset:2021-08-18
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006D21A / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Aphasia, Blood pressure immeasurable, Death, Hypopnoea, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-18
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ASA BUMETANIDE CARVEDILOL ENTRESTO FERROUS SULFATE LEVSIN SPIRONOLACTONE
Current Illness: ENCOUNTER FOR AUTISM SCREENING ACUTE EMBOLISM & THROMBOSIS OF OTHER SPECIFIED VEINS OBESITY IRON DEFICIENT ANEMIA ACUTE ON CHRONIC COMBINED SYSTOLIC & DIASTOLIC CONGESTIVE HEART FAILURE HEART FAILURE DUCHENNE OR BECKER MUSCULAR DYSTROPHY PULMONARY HTN MILD PROTEIN-CALORIE MALNUTRITION
Preexisting Conditions: SEE ABOVE
Allergies: NKDA
Diagnostic Lab Data: UNKNOWN
CDC Split Type:

Write-up: RESIDENT REC''D FIRST DOSE MODERNA VACCINE LEFT DELTOID AT 1334. PROGRESS NOTE FROM FACILITY READS: 8/18/21 @ 15:11- "RESIDENT IS ALERT AND WATCHES TV IN HIS (?) FOR ENTERTAINMENT. RESIDENT RECEIVES ROOM VISITS AND MONITORING NEEDS AND INTEREST." 8/18/21 @ 20:50- "RESIDENT WAS UNRESPONSIVE WITH SHALLOW BREATHING, EYES OPEN BUT VERBALLY NO SOUND, PLACED RESIDENT ON 02 @ 3 LITERS PER NASAL CANNULA, NOTIFIED NP OF RESIDENTS STATUS RECEIVED ORDERS TO SEND RESIDENT TO HOSPITAL VIA 911, NOTIFIED 911, 911 UNABLE TO GET A BP ON RESIDENT, RESIDENT SAFELY TRANSFERRED TO STRETCHER FOR TRANSPORT TO ER, RESIDENT FAMILY NOTIFIED, RN NOTIFIED." RN STATES THEY REC''D WORD THAT PT HAD EXPIRED BETWEEN 8:50 AND 10:14PM.


VAERS ID: 1700329 (history)  
Form: Version 2.0  
Age: 18.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-07-23
Onset:2021-08-30
   Days after vaccination:38
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNAVAILABLE / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Activated partial thromboplastin time prolonged, Acute kidney injury, Acute myocardial infarction, Acute respiratory failure, Alanine aminotransferase increased, Anisocytosis, Aspartate aminotransferase normal, Base excess abnormal, Basophil count, Basophil percentage decreased, Blood albumin decreased, Blood bicarbonate decreased, Blood calcium decreased, Blood chloride normal, Blood creatinine normal, Blood fibrinogen decreased, Blood glucose increased, Blood magnesium normal, Blood pH normal, Blood potassium normal, Blood sodium normal, Blood urea increased, Bronchoscopy abnormal, Calcium ionised decreased, Carbon dioxide abnormal, Carbon dioxide decreased, Cardiac arrest, Catheterisation cardiac abnormal, Chest X-ray abnormal, Coronary artery occlusion, Culture, Death, Dyspnoea, Electrocardiogram abnormal, Endotracheal intubation, Eosinophil count decreased, Eosinophil percentage decreased, Fatigue, Fibrin D dimer, Full blood count, Haematocrit decreased, Haemofiltration, Haemoglobin decreased, Haemorrhage, Hypoxia, Immature granulocyte count increased, Intensive care, International normalised ratio increased, Lung assist device therapy, Lung opacity, Lymphocyte count decreased, Lymphocyte percentage decreased, Mean cell haemoglobin concentration decreased, Mean cell haemoglobin normal, Mean cell volume increased, Mean platelet volume increased, Mechanical ventilation, Metabolic function test, Monocyte count, Monocyte percentage decreased, Myocardial infarction, Neutrophil count increased, Oxygen saturation decreased, PCO2 decreased, PO2 decreased, Platelet count decreased, Prothrombin time prolonged, Pulmonary alveolar haemorrhage, Pulmonary haemorrhage, Pyrexia, Red blood cell count decreased, Red blood cell nucleated morphology present, Red cell distribution width increased, Right ventricular failure, SARS-CoV-2 test negative, Sepsis, Septic shock, Sinus tachycardia, Tachycardia, Urine analysis normal, Vomiting, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Lactic acidosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Infective pneumonia (broad), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: ergocalciferol, vitamin D2, 50,000 Units capsule pimecrolimus cream (ELIDEL) 1 % cream triamcinolone ointment (KENALOG) 0.1 % ointment
Current Illness: Lupus
Preexisting Conditions: Lupus diagnosis on 7/21/21
Allergies: Bactrim
Diagnostic Lab Data: Results for patient 9/1/2021 04:10 Arterial pH: 7.35 Arterial pCO2: 31.5 (L) Arterial pO2: 71.6 Arterial HCO3: 16.8 (L) Arterial Total CO2: 17.8 (L) Arterial Base Excess/Deficit: -7.6 Arterial Measured O2 Saturation: 90.0 Sodium Blood: 136 Potassium Blood: 4.4 Chloride Blood: 114 (H) Carbon Dioxide: 17.8 (L) Glucose Blood: 241 (H) BUN: 27 (H) Creatinine Blood: 0.82 Calcium Blood: 6.8 (L) WBC: 11.3 (H) RBC: 2.33 (L) Hemoglobin: 7.2 (L) Hematocrit: 22.8 (L) MCV: 97.9 MCH: 30.9 MCHC: 31.6 (L) Platelet Count: 184 MPV: 11.4 (H) RDW: 17.9 (H) Nucleated RBC Automated: 0.2 (H) Differential Type: MANUAL DIFF % Seg: 97.5 (H) % Lymphocytes: 1.0 (L) % Monocytes: 1.0 % Meta: 0.5 (H) Absolute Neutrophils: 11.018 (H) Abs Seg: 11.02 (H) Absolute Lymphocytes: 0.11 (L) Absolute Monocytes: 0.11 Abs Meta: 0.06 (H) Total Cells Counted: 198 Anisocytosis: SLIGHT Results for patient 9/1/2021 13:38 Arterial pH: 7.11 (LL) Arterial pCO2: 62.6 (HH) Arterial pO2: 70.3 Arterial HCO3: 18.8 (L) Arterial Total CO2: 20.7 Arterial Base Excess/Deficit: -12.7 Arterial Measured O2 Saturation: 85.2 (L) Sodium Blood: 137 Potassium Blood: 4.7 Chloride Blood: 119 (H) Carbon Dioxide: 20.7 (L) Glucose Blood: 226 (H) BUN: 31 (H) Creatinine Blood: 0.89 Calcium Blood: 6.6 (L) WBC: 17.0 (H) RBC: 2.90 (L) Hemoglobin: 8.9 (L) Hematocrit: 28.7 (L) MCV: 99.0 MCH: 30.7 MCHC: 31.0 (L) Platelet Count: 187 MPV: 11.0 (H) RDW: 16.9 (H) Nucleated RBC Automated: 0.1 (H) Differential Type: AUTOMATED DIFF % Neutrophils: 94.1 (H) % Imm Gran: 1.2 (H) % Lymphocytes: 1.1 (L) % Monocytes: 3.2 % Eosinophils: 0.0 % Basophils: 0.4 Absolute Neutrophils: 15.930 (H) Abs Imm Gran: 0.21 (H) Absolute Lymphocytes: 0.19 (L) Absolute Monocytes: 0.55 (H) Absolute Eosinophils: 0.00 Absolute Basophils: 0.07 Results for patient 9/4/2021 16:04 Arterial pH: 7.40 Arterial pCO2: 47.4 (H) Arterial pO2: 60.2 (L) Arterial HCO3: 28.5 (H) Arterial Total CO2: 29.9 (H) Arterial Base Excess/Deficit: 3.7 Arterial Measured O2 Saturation: 89.7 (L) Sodium Blood: 146 (H) Potassium Blood: 3.0 (L) Chloride Blood: 106 Carbon Dioxide: 29.9 Glucose Blood: 176 (H) BUN: 67 (HH) Creatinine Blood: 2.53 (H) Calcium Blood: 8.3 (L) Ionized Calcium: 4.66 Magnesium Blood: 1.9 WBC: 8.7 RBC: 2.47 (L) Hemoglobin: 7.2 (L) Hematocrit: 21.9 (L) MCV: 88.7 MCH: 29.1 MCHC: 32.9 Platelet Count: 96 (L) MPV: 11.2 (H) RDW: 16.1 (H) Nucleated RBC Automated: 0.6 (H) Differential Type: AUTOMATED DIFF % Neutrophils: 93.0 (H) % Imm Gran: 1.6 (H) % Lymphocytes: 1.5 (L) % Monocytes: 3.7 % Eosinophils: 0.0 % Basophils: 0.2 Absolute Neutrophils: 8.120 (H) Abs Imm Gran: 0.14 (H) Absolute Lymphocytes: 0.13 (L) Absolute Monocytes: 0.32 Absolute Eosinophils: 0.00 Absolute Basophils: 0.02 PT Result: 16.1 (H) INR Result: 1.25 PTT Result: 94.3 (H) TT Result: $g100.0 (H) D Dimer: 2.56 (H) Fibrinogen: 192 (L) Heparin Level.: 0.36 PREOPERATIVE DIAGNOSIS: STEMI POSTOPERATIVE DIAGNOSIS: stemi Procedure(s): Left heart catheterization with coronary angiography JL3 and SCR ANESTHESIA: General ESTIMATED BLOOD LOSS: Minimal COMPLICATIONS: None CONDITION: Critical ACCESS: 5 Fr left FA FINDINGS: Totally occluded left anterior descending & circumflex coronary arteries. Right coronary artery patent
CDC Split Type:

Write-up: Patient is a 18 y.o. male patient with a past medical history significant for lupus who presents with Pulmonary hemorrhage. About 2 days ago, pt developed fevers and worsening shortness of breath. T max 102 F at home. He did not note anything that relieved or exacerbated his difficulty breathing. He also reported fatigue, abdominal pain and several episodes of NBNB emesis the week prior to admission. No recently chest pain, diarrhea, hematuria, dysuria, headache or neck stiffness. Pt presented to ED yesterday and was treated with antibiotics and discharged, he came back today due to worsening shortness of breath. Of note, pt was had 2 hospital admissions in the last 2 months, most recently for febrile neutropenia. Completed 2 doses of COVID vaccine. At ED, pt arrived with temp of 39.1, HR 143, RR 28, BP 117/67, SpO2 98% EKG with sinus tachycardia, no ST elevations/depressions or other acute ischemic changes. CXR revealed diffuse bilateral airspace opacities without pneumothorax. CBC 10.6$g8.1/27.4<203, CMP 137/3.9/110/22/18/0.58<99, Ca 7, Alb 1.5, AST 15, ALT 86. UA negative for infection, no protein. CXR with progressive diffuse bilateral airspace opacity with air bronchograms, no pneumothorax. Cultures obtained. Pt was treated with vancomycin, cefepime and levofloxacin for sepsis and concern for pneumonia and given IV fluids per ED sepsis protocol. He was also given Solumedrol 1g. Less likely COVID given vaccination status and negative COVID swab. Due to worsening tachycardia and hypoxia on oxygen, pt was intubated and bleeding in airway was noted. Pt was admitted to the ICU, and pulm crit care performed a bronchoscopy that revealed diffuse alveolar hemorrhage. Repeat CXR in ICU revealed almost complete white out of both lungs. Pt was bagged for almost an hour due to persistent hypoxia. Pt was subsequently transferred to CW due to concern for requiring VV ECMO. On arrival to CW CICU, pt satting low 70s, vent settings titrated and sats improved to 90s. He was continued on Epi, Norepi, Dexmed and Fentanyl. Rheum history: Lupus diagnosed on renal biopsy 7/21/21, on bactrim prophylaxis recently, recent treatment with rituximab, on daily prednisone 30 mg BID Parents spanish speaking. Patient is a 18 y.o. male patient with a past medical history significant for lupus who presents with acute hypoxic respiratory failure requiring mechanical ventilation, septic shock and pulmonary hemorrhage. It is unclear at this time if his pulmonary hemorrhage is related to lupus vs idiopathic process. COVID negative and fully vaccinated, making COVID pneumonia less likely. He is maintaining his MAPs on epinephrine and arterial sats in the 90s on SIMV PC PS. He is candidate for VV ECMO but does not require it at this time due to decreasing vent settings. Rheumatology consulted and large lab workup is underway. Plan to continue broad spectrum antibiotics, close monitoring of hemodynamics and to continue to watch for signs of recurrent pulmonary hemorrhage. Pt requires CICU due to risk of acute cardiopulmonary decompensation. Patient was an 18 yo man with Dx of lupus who presented to hospital (transferred from outside hospital) in respiratory failure due to pulmonary hemorrhage. Due to worsening hypoxemia in spite of mechanical ventilation he was started on VV ECMO. While on VV ECMO, he had a cardiac arrest due to right ventricular failure and was converted to VA ECMO. He also developed acute renal failure and was on CRRT. On 9/14, while on VA ECMO, he developed a massive MI due to occlusion of his LAD and circumflex coronaries. This heart injury was assessed as non recoverable and all further care was considered futile. After given time to the family to say their goodbyes, patient was removed from VA ECMO support and pronounced dead with his family at the bedside on 9/15/2021 at 7:30 am


VAERS ID: 1700774 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Male  
Location: Alabama  
Vaccinated:2021-09-13
Onset:2021-09-15
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 - / IM

Administered by: Work       Purchased by: ?
Symptoms: Anion gap increased, Ascites, Blood bicarbonate decreased, Blood chloride decreased, Blood creatinine increased, Blood glucose normal, Blood lactic acid increased, Blood pH decreased, Blood potassium normal, Blood sodium decreased, Blood urea increased, COVID-19, Cardiac arrest, Cardiac failure, Cardiogenic shock, Cardiomegaly, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Congestive hepatopathy, Death, Electrocardiogram ST segment elevation, Fibrin D dimer increased, Glomerular filtration rate decreased, Hepatic failure, Hepatomegaly, Hyperventilation, Inflammation, Metabolic acidosis, Myocarditis, PCO2 decreased, Pericardial effusion, Pneumonia, Renal disorder, Renal failure, SARS-CoV-2 test positive, Troponin increased
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Lactic acidosis (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (broad), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (narrow), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Active COVID-19 infection suspected based on symptom onset 9/10/2021. Tested positive yesterday, 9/14 and confirmed today in our ED, 9/15.
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: EKG showing diffuse ST elevations concerning for myocarditis. Cardiologist did not feel that transfer to a higher level care center immediately for cardiac catheterization indicated. Troponin 113.793. Lactate 14.0. Creatinine 2.97. pH 7.124. Bicarb 9. Anion gap 30. Glucose 144. Sodium 135 potassium 4 chloride 96. BUN 22. SARS-CoV-2 detected. Per radiology: CTA chest: Small to moderate relatively hyperdense pericardial effusion, nonspecific. Mild cardiomegaly. Evidence of heart failure. These findings collectively would be compatible with inflammatory disease. Consider myocarditis or pericarditis. No evidence of pulmonary thromboembolism. Bilateral pneumonia. CTA abdomen and pelvis: No evidence of bowel ischemia. The enlargement of the liver and of mild ascites suggest hepatic congestion. This could reflect either heart failure or liver failure. Heterogeneous appearance of the kidneys, suggesting possible pyelonephritis, but this appearance could also be the result of some other inflammatory process.
CDC Split Type:

Write-up: Death. Presented to the emergency department with diffuse ST elevations concerning for myocarditis. His troponin was elevated at 113. His lactate was 14. He was in renal failure with a creatinine of 2.97, GFR 26. D-dimer was elevated at 1.25 without any obvious pulmonary embolism according to the CT. Upon presentation he was hyperventilating, not complaining of chest pain. Labs demonstrate a significant metabolic acidosis with a pH of 7.124, PCO2 of 15.4. O2 sat 96.8% on room air. Patient unfortunately went into cardiac arrest and was unable to be revived. Cause of death suspected to be myocarditis and cardiogenic shock In the setting of active COVID-19 infection.


VAERS ID: 1703893 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-05-26
Onset:2021-06-30
   Days after vaccination:35
Submitted: 0000-00-00
Entered: 2021-09-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA O4SC21A / 1 - / SYR
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011021A / 2 - / SYR

Administered by: Other       Purchased by: ?
Symptoms: Autopsy, Cardiomyopathy, Death, Toxicologic test normal
SMQs:, Cardiomyopathy (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-30
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Carvedilol, Entresto, Spironolactione
Current Illness: None
Preexisting Conditions: None
Allergies: NKDA
Diagnostic Lab Data: Negative toxicology, evidence of cardiomyopathy on autopsy
CDC Split Type:

Write-up: Death occurred 7 days after the second dose


VAERS ID: 1732186 (history)  
Form: Version 2.0  
Age: 23.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-01
Onset:2021-09-01
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 004C21A / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, Cardioversion, Death, Malaise, Myocardial infarction, Nausea, Respiratory arrest, Resuscitation, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-02
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: xyzal
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Paramedics stated he died of heart attack.
CDC Split Type:

Write-up: Patient began complaining about not feeling well. He was nauseated and began throwing up and going to the bathroom. That continued off and on all night. Around 6:30 - 6am the next morning he said he was feeling somewhat better but was very weak. H e went back to bed. We checked on him around lunch time lying on his bed with his phone in his hand. He appeared to be trying to text. I checked on him a few minutes later and he had not moved. I checked and saw he wasn''t breathing. At that time he had a heart beat. We called 911 and I started CPR and continued for approx 25 until paramedics arrived. They bagged him and used defibrillator but could not bring him back.


VAERS ID: 1780517 (history)  
Form: Version 2.0  
Age: 20.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-10
Onset:2021-09-11
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 LA / SYR

Administered by: Other       Purchased by: ?
Symptoms: Dyspnoea, Myocardial infarction
SMQs:, Anaphylactic reaction (broad), Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-11
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: uptravi, Sildenafil,Letairis
Current Illness: no
Preexisting Conditions: Long QT,Pulmonary Hypertension
Allergies: no
Diagnostic Lab Data:
CDC Split Type:

Write-up: Had a heart attack and was gasping for air


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