Highlights
- •COVID 19 vaccines currently approved or authorized are effective in preventing serious outcomes of COVID 19, including severe disease, hospitalization, and death.
- •The safety of COVID 19 vaccines is continuously monitored and evaluated.
- •SCARs including DRESS are possible adverse reactions to COVID 19 vaccines.
- •It's essential that physicians continue to be trained to recognize and appropriately treat these types of reactions.
Abstract
Introduction
Italian Superior Institute of Health - Epicentro-ISS, Istituto Superiore di Sanità. At: https://www.epicentro.iss.it/vaccini/covid-19-piano-vaccinazione last access in 10/25/2021.
AIFA Pharmacovigilance on COVID-19 Vaccines. At: https://www.aifa.gov.it/farmacovigilanza-vaccini-covid-19 Last access in 11/17/2021.
AIFA Pharmacovigilance on COVID-19 Vaccines. At: https://www.aifa.gov.it/farmacovigilanza-vaccini-covid-19 Last access in 11/17/2021.
GRESIF (multiregional pharmacovigilance project "Severe systemic drug hypersensitivity reactions"). Delibera del progetto multiregionale “Gravi reazioni sistemiche da ipersensibilità a farmaci (GRESIF)” At: https://www.ospedaleniguarda.it/uploads/default/attachments/albo_pretorio/albo_pretorio_m/25586/files/allegati/33687/delib1267_ov.pdf Last access in 12/20/2021.
- Griffin DWj
- Martin GE
- McLean C
- et al.
Case report


Score | -1 | 0 | 1 | 2 | Min | Max |
---|---|---|---|---|---|---|
Fever ≥ 38.5°C | No/U | Yes | -1 | 0 | ||
Lymphadenopathy | No/U | Yes | 0 | 1 | ||
Eosinophilia Eosinophils Eosinophils, if leukocytes < 4000 | 700-1499/µl 10-19.9% | ≥ 1500/µl ≥ 20% | 0 | 2 | ||
Atypical lymphocytes | No/U | Yes | 0 | 1 | ||
Skin involvement Rash extent (> 50% BSA) Rash suggesting DRESS Biopsy suggesting DRESS | No No | No/U U Yes/U | Yes Yes | -2 | 2 | |
Organ involvement* Liver, Kidney, Lung, Muscle/heart, pancreas, other organ(s) | No/U | Yes | 0 | 2 | ||
Resolution ≥ 15 days | No/U | Yes | -1 | 0 | ||
Evaluation other potential causes ANA, blood culture, serology for HVA/HBV/HCV, C./M. pneumoniae, other serology/PCR if none positive and ≥ 3 of above negative | Yes | 0 | 1 | |||
TOTAL SCORE | -4 | 9 |
Discussion
- Griffin DWj
- Martin GE
- McLean C
- et al.
Conclusions
Declaration of Competing Interest
Funding sources
References
Italian Superior Institute of Health - Epicentro-ISS, Istituto Superiore di Sanità. At: https://www.epicentro.iss.it/vaccini/covid-19-piano-vaccinazione last access in 10/25/2021.
AIFA Pharmacovigilance on COVID-19 Vaccines. At: https://www.aifa.gov.it/farmacovigilanza-vaccini-covid-19 Last access in 11/17/2021.
GRESIF (multiregional pharmacovigilance project "Severe systemic drug hypersensitivity reactions"). Delibera del progetto multiregionale “Gravi reazioni sistemiche da ipersensibilità a farmaci (GRESIF)” At: https://www.ospedaleniguarda.it/uploads/default/attachments/albo_pretorio/albo_pretorio_m/25586/files/allegati/33687/delib1267_ov.pdf Last access in 12/20/2021.
- Spanish Guidelines of Diagnosis, Management, Treatment and Prevention of DRESS syndrome.J Investig Allergol Clin Immunol. 2020; 30: 229-253https://doi.org/10.18176/jiaci.0480
- A case of drug reaction with eosinophilia and systemic symptoms (DRESS) without a typical precipitant.Med J Aust. 2020; 212 (.e1Epub 2020 Feb 24. PMID: 32092152): 300-301https://doi.org/10.5694/mja2.50519
- A case of severe cutaneous adverse reaction following administration of the Janssen Ad26.COV2.S COVID-19 vaccine.JAAD Case Rep. 2021; 13: 134-137https://doi.org/10.1016/j.jdcr.2021.05.010
- Drug reaction with eosinophilia and systemic symptoms syndrome following vaccination with the AstraZeneca COVID-19 vaccine.JAAD Case Rep. 2022; 20: 14-16https://doi.org/10.1016/j.jdcr.2021.11.028
- Comments on: DRESS syndrome.J Am Acad Dermatol. 2014; 71 (-1000.e2): 1000https://doi.org/10.1016/j.jaad.2013.11.053
- Updates and insights in the diagnosis and management of DRESS syndrome.Curr Dermatol Rep. 2021; : 1-13https://doi.org/10.1007/s13671-021-00348-z
- Role of Multiple Comorbidities and Therapies in Conditioning the Clinical Severity of DRESS: A Mono-Center Retrospective Study of 25 Cases.Int J Mol Sci. 2021; 22: 7072https://doi.org/10.3390/ijms22137072