First case of postmortem study in a patient vaccinated against SARS CoV2

Hansen, Torsten; Titze, Ulf; Kulamadayil-Heidenreich, Nidhi Su Ann; Glombitza, Sabine; Tebbe, Johannes Josef; Röcken, Christoph; Schulz, Birte; Weise, Michael; Wilkens, Ludwig

A previously symptomless 86-year-old man received single mRNA vaccine BNT162b2. Four weeks later, he succumbed to death due to acute renal and respiratory failure. Although he did not present with any symptoms specific for Coronavirus disease 19 (COVID19), he obtained positive testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), before he died. S1 antigen-binding notably showed significant levels for IgG, while nucleocapsid IgG/IgM was not elicited . By means of autopsy, acute bronchopneumonia and acute tubular failure were assigned as cause death of death. However, we did not observe any characteristic morphological features of COVID19. Postmortem molecular mapping by real time-polymerase chain reaction (RT-PCR) additionally revealed relevant SARS-CoV-2 Ct values in all organs examined (oropharynx, olfactory mucosa, trachea, lungs, heart, kidney, and cerebrum) except for liver and olfactory bulb. These results might contribute to the view that first vaccination induces immunogenicity, but not sterile immunity.