Sex: M
Vaccine: COVID19
Symptoms: Hypotension, Left ventricular failure
Clinical narrative: Hyperlipidemia; Hyperglycemia; HYPOTENSION; Acute respiratory failure with hypoxia and hypercapnia; Chronic HFrEF (heart failure with reduced ejection fraction); Coronary artery disease involving native coronary artery of native heart without angina pectoris; Paroxysmal atrial fibrillation; This is a spontaneous report received from contactable reporter(s) (Physician and Other HCP).  A 93-year-old male patient received bnt162b2, bnt162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), on 30Sep2022 as dose 5 (booster), single (Lot number: GJ2524) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: covid-19 pfr 30 mcg (covid-19 pfizer monovalent 12 yr.+(purple cap)) (DOSE 1, SINGLE, Lot Number: EN6200), administration date: 14Mar2021, for COVID-19 Immunization; covid-19 pfr 30 mcg (covid-19 pfizer monovalent 12 yr.+(purple cap)) (DOSE 2, SINGLE, Lot Number: EN6207), administration date: 05Apr2021, for COVID-19 Immunization; covid-19 pfr 30 mcg (covid-19 pfizer monovalent 12 yr.+(purple cap)) (DOSE 3 (BOOSTER), SINGLE, Lot Number: 320308D), administration date: 28Oct2021, for COVID-19 Immunization; covid-19 pfr-bnt 30mcg/0.3ml (covid-19 pfizer monovalent tris- sucrose, 12 yr. +) (DOSE 4 (BOOSTER), SINGLE, Lot Number: FK9894), administration date: 07Apr2022, for COVID-19 Immunization. The following information was reported: ATRIAL FIBRILLATION (death, medically significant) with onset 27Jan2023, outcome "fatal", described as "Paroxysmal atrial fibrillation"; LEFT VENTRICULAR FAILURE (death, medically significant) with onset 16Oct2023, outcome "fatal", described as "Chronic HFrEF (heart failure with reduced ejection fraction)"; CORONARY ARTERY DISEASE (death) with onset 16Oct2023, outcome "fatal", described as "Coronary artery disease involving native coronary artery of native heart without angina pectoris"; ACUTE RESPIRATORY FAILURE (death, medically significant) with onset 19Oct2023, outcome "fatal", described as "Acute respiratory failure with hypoxia and hypercapnia"; HYPERLIPIDAEMIA (death), outcome "fatal", described as "Hyperlipidemia"; HYPERGLYCAEMIA (death), outcome "fatal", described as "Hyperglycemia"; HYPOTENSION (death), outcome "fatal". Therapeutic measures were taken as a result of atrial fibrillation, acute respiratory failure, left ventricular failure, coronary artery disease, hyperlipidaemia, hyperglycaemia, hypotension: Insulin regular (HumaLIN R injection) for Hyperglycemia, Intravenous, 6 IU TID from 20-24Oct2023; Hydromorphone (Dilaudid Injection) for chest pain, Intravenous, 1 mg QD from 22-24Oct2023; Norepinephrine infusion for hypotension, intravenous, 80mcg PRN from 22-24Oct2023; Tocilizuman (Actemra infusion), intravenous, 400mg QD on 20Oct2023; Apixaban (Eliquis tablet) for DVT prophylaxis, oral, 2.5 mg BID from 16-24Oct2023; Aspirin (Aspirin EC tablet) for coronary artery disease, oral, 81mg BID from 20-24Oct2023; Atorvastatin (Lipitor tablet) for hyperlipidemia, oral 80mg QD from 18-23Oct2023; Digoxin (Lanoxin tablet) for paroxysmal atrial fibrillation, oral, 125mcg QD from 18-22Oct2023; Empagliflozin (Jardiance tablet) for hyperlipidemia, oral, 10mg BID from 20-23Oct2023; Metoprolol tartrate (Lopressor tablet) for coronary artery of native heart without angina pectoris, oral, 25 mg BID from 20-24Oct2023; Haloperidol lactate (Haldol injection), intravenous, 5mg QD on 19Oct2023; Vancomycin (Vancocin infusion) for hospital acquired pneumonia prophylaxis, intravenous, 1000mg QD on 19Oct2023; Cefepime (Maxipime infusion) for hospital acquired pneumonia prophylaxis, intravenous, 1g QD on 19Oct2023; Heparin (Porcine injection) for prophylaxis, intravenous, 2000 IU QD from 19-20Oct2023; Ipratropium-Albuterol (Duo-neb nebulizer solution) for difficulty in breathing, resp inhalation, 3mL every 5 hours pm 19-23Oct2023; Bumetanide (Bumex tablet) for volume overloaded associated edema, oral, 20mg QD on 18Oct2023; Furosemide (Lasix injection) for volume overloaded associated edema, intravenous, 10mg QD from 17-18Oct2023; Simvastatin (Zocor tablet) for hyperlipidemia, oral, 20mg QD on 16Oct2023. The patient date of death was 24Oct2023. Reported cause of death: "Paroxysmal atrial fibrillation", "Acute respiratory failure with hypoxia and hypercapnia", "Chronic HFrEF (heart failure with reduced ejection fraction)", "Coronary artery disease involving native coronary artery of native heart without angina pectoris", "Hyperlipidemia", "Hyperglycemia", "HYPOTENSION" (also reported as disease progression). It was not reported if an autopsy was performed. Causality assessment: Event Possibly Related to COVID-19 PFR Bivalent 30mcg/0.3mL (COVID-19, Pfizer Bivalent Tris- Sucrose, 12 Yr. +): No.; Sender's Comments: All reported fatal events occurred 3 months after (bnt162b2, bnt162b2 omi ba.4-5), are associated with the advanced old patient underling medical conditions unrelated to the booster vaccine use; Reported Cause(s) of Death: Paroxysmal atrial fibrillation; Acute respiratory failure with hypoxia and hypercapnia; Chronic HFrEF (heart failure with reduced ejection fraction); Coronary artery disease involving native coronary artery of native heart without angina pectoris; Hy