It’s an 86 year old only partially vaccinated individual so likely inadequate immune response to a partial vaccine to start…..
I also do not know which vaccine. It could be Astra-Zeneca, being Germany I guess.
And I wasn’t clear but they seemed to indicate he got the virus from a patient AFTER he came to the hospital for diarrhea. Ostensibly NOT COVID diarrhea.
So this is just telling us an old man with many problems who only just had one part of the vaccine process got in contact with a COVID patient and then died.
So now, did he die from COVID or diarrhea?
Actually, if you read the paper, they looked hard for typical SARS CoV 2 lung injury and didn’t find it. He had ischemic bowel and died of sepsis and bacterial lung infection.
He was clearly viremic. What role if any that played in his demise is unclear.
Antibody dependent enhancement in dengue causes typical hemorrhagic fever. This is a very interesting case, it’s important to keep looking for ADE and to keep an open mind - but that’s probably not what this case was.
It may turn out that the choice of mRNA for spike, although easy to understand (and technologically spectacular) does not evoke the correct target.
Vaccinated or not he was fine until the medical system got hold of him.