Reactive systemic vasculitis in the course of a coronavirus OC43 infection: a case report

Abstract

This case report details a severe systemic failure following a coronavirus OC43 (HCoV-OC43) infection. A 78-year-old man, who had been vaccinated against SARS-CoV-2, was hospitalized for a flu-like infection and abdominal pain, revealing bilateral hemorrhagic adrenal infarctions with secondary adrenal failure. Imagery examinations showed adrenal necrosis and multiple ischemic cerebral strokes. A multiplex retro-transcriptase polymerase chain reaction (RT-PCR) became positive for HCoV-OC43. Cardio-vascular, infectious, and auto-immune exams were negative. A steroid medication finally allowed clinical improvement, and the diagnosis of reactional vasculitis was retained. An unknown pathogenicity of HCoV-OC43 is possible, considering that RT-PCR research is rarely made. The hypothesis of cross-reactions with SARS-CoV-2 antivaccine antibodies is also feasible. At last, the possible former virulence of HCoV-OC43 is being researched, in the event that this virus is connected to the 1889 Russian influenza pandemic. The development of multiplex RT-PCR would enable the study of other HCV-OC43 infections.

Keywords

• coronavirus OC43
• vasculitis
• COVID-19
• cross-reaction
• Russian influenza