Sex: M
Vaccine: COVID19, COVID19
Symptoms: Albumin CSF, Arteriogram carotid, COVID-19, CSF culture, CSF glucose
Clinical narrative: tested positive for COVID-19 upon admission; tested positive for COVID-19 upon admission; This is a literature report for the following literature source(s):   A 62-year-old male patient received BNT162b2, as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation; BNT162b2, as dose 1, single (Batch/Lot number: unknown) and as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "diabetes mellitus" (ongoing); "hypertension" (ongoing); "hyperlipidemia" (unspecified if ongoing); "coronary artery disease" (unspecified if ongoing); "coronary artery bypass grafting", start date: 2009 (unspecified if ongoing); "cerebral vascular disease" (unspecified if ongoing). The patient's concomitant medications were not reported. The author presented the case of a 62-year-old male with a past medical history of diabetes mellitus, hypertension, hyperlipidemia, and coronary artery disease requiring coronary artery bypass grafting in 2009 complicated by cerebral vascular disease with no residual weakness who presented to the emergency department with generalized weakness, most significant in his right hand of one-day duration. He also had subjective fever and chills. The patient stated that his symptoms began six days ago, the same day he received the COVID-19 vaccine booster (Pfizer-BioNTech COVID-19 vaccination). He had already received two doses of the Pfizer vaccine seven months ago. Of note, immediately before receiving the COVID-19 booster vaccination, the patient had four days of diarrhea. He denied slurred speech, chest pain, shortness of breath, nausea, vomiting, diarrhea, recent travel, and sick contact. Physical examination was relatively benign, except for 3/5 strength in both upper and lower extremities. Vitals, basic metabolic panel, and complete blood count were within normal limits. However, he tested positive for COVID-19 upon admission. He did not exhibit any respiratory symptoms and did not require any supplemental oxygen. Head computed tomography (CT) showed no acute intracranial pathology. CT angiogram of the brain and neck were negative for acute vessel occlusion. The patient's weakness quickly worsened as his strength decreased to 1/5 in both upper and lower extremities with decreased deep tendon reflexes and developed mild dysphagia. Neurology was consulted and recommended performing a lumbar puncture followed by starting IVIG therapy for possible GBS. CSF findings were significant for mildly elevated protein of 58 mg/dL (normal range: 15-45 mg/dL) and normal white blood cell (WBC) count of 2/mcL (normal range: 0-5/mcL). These findings demonstrate ACD that was typical of GBS. On hospital day 28, the patient finally tested negative for COVID-19 and was discharged. In the author's case, whether the patient was asymptomatic at the onset of GBS symptoms or if symptoms of both GBS and COVID-19 started together was unclear. The patient underwent the following laboratory tests and procedures: Albumin CSF (14-25): 40.2 mg/dl; Arteriogram carotid: negative, notes: no hemodynamically significant carotid artery stenosis. negative for acute vessel occlusion; Computerised tomogram head: Negative, notes: showing no acute large vessel occlusion; showed no acute intracranial pathology, notes: without contrast; CSF culture: No growth at 14 days; CSF glucose (40-70): 66 mg/dl; CSF oligoclonal band: Absent; CSF protein (15-45): 58 mg/dl; CSF red blood cell count (0-1): 5 /mm3; CSF red blood cell count (0-0): 5 /mm3; CSF test: Colorless, notes: Color; Clear, notes: Appearance; No acid-fast bacilli isolated after six weeks; CSF test (normal high range 3.4): 4.7 mg/dl; CSF white blood cell count (0-5): 2 /mm3, notes: /mcL, normal; 3 /mm3; Full blood count: normal; Magnetic resonance imaging: can aid in excluding other causes of acute, notes: flaccid paralysis; Metabolic function test: normal; Physical examination: relatively benign, except for 3/5 strength, notes: in both upper and lower extremities; strength decreased to 1/5, notes: in both upper and lower extremities with decreased deep tendon reflexes and developed mild dysphagia; SARS-CoV-2 test: positive, notes: upon admission; negative, notes: On hospital day 28; Vital signs measurement: normal.  No follow-up attempts are possible.; Sender's Comments: Vaccine efficacy varies from person to person and is affected by many factors. The association between the event drug ineffective (CoVID-19) with the suspect product BNT162B2 cannot be fully excluded.,Linked Report(s) : US-PFIZER INC-PV202400004220 Same article/drug/patient and different event;