Accelerated Extensive Lung Fibrosis Post–COVID-19 Immunization in an Asthmatic Patient

We describe a unique case of a 60-year-old asthmatic Saudi patient who developed acute respiratory distress syndrome (ARDS) and accelerated lung fibrosis after the administration of the second dose of the COVID-19 mRNA vaccine. This patient presented to the emergency room with a four-day history of fever, shortness of breath, and cough. His hospitalization was complicated by non-ST segment elevation myocardial infarction, non-sustained ventricular tachycardia, and a lowered Glasgow Coma Scale. He was intubated at a P/F ratio of 73 mmHg and a peak inspiratory pressure of 46 cmH2O. His antibiotics had to be modified, as he had QT prolongation. Additional anti-pseudomonal, anti-anaerobe, and anti-fungal coverings were empirically given, which were later switched to colistin based on the results of a sputum culture. On ICU day 17, the patient went into cardiac arrest due to severe ARDS and septic shock. Despite attempts at resuscitation, he was unable to be revived.