A young orthopedic surgeon with OrthoSouth who died early Monday, Feb. 8, may be the nation’s first case of an adult who died of a delayed immune response to COVID and had received the vaccine.

Dr. J. Barton Williams died early Monday at Baptist Memorial Hospital-Memphis. He was 36.

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“What we think so far is that he suffered from multi-system inflammatory syndrome (MIS),” said Baptist infectious disease expert Dr. Stephen Threlkeld.

The syndrome, more common in children, often looks and acts like Kawasaki disease, which causes inflammation in the blood vessels.

MIS is a reaction in someone who has had the COVID infection weeks or months earlier and mounted a severe, delayed immune reaction, which often causes significant damage to the organs.

Williams told doctors he was not aware of having had COVID and he tested negative several times in the hospital, which is not unusual, Threlkeld said, because he could have had COVID long enough ago that he would no longer test positive.

MIS is essentially an unchecked immunological response to the virus, said Dr. Scott Strome, executive dean of the College of Medicine at University of Tennessee Health Science Center.

“The immune system’s response is to eradicate the virus. One of its most fundamental features is its ability to turn itself off when it’s done,” Strome said.

“It has to know when it’s done. It if doesn’t have that, you get an autoimmune situation. Whatever the reason, the body still thinks it has a threat and doesn’t turn itself off. Then you get this systematic inflammation.”

Some drugs are effective in turning the immune system off.

“No one is going to know enough now to know which drugs to give yet,” Strome said. “That is the challenge.”

Multi-system inflammatory illness does not have any relationship to how severely ill someone was with COVID, Threlkeld said.

“The only way we know that he had been infected was that he did have the antibody,” Threlkeld said.

The antibody in Williams’ blood was the natural infection, not from the vaccine. 

An official cause of death has not yet been determined.

“There is still information to be gathered,” Threlkeld said. “There is an autopsy pending, and we are working closely daily with the CDC.

“We want to be sure there is no indication that there is any relationship to the vaccine at this point,” he said.

“It is difficult to make sweeping conclusions in any direction when you are talking about something that has not been reported before anywhere,” Threlkeld added. “No one previously has been reported to have this illness (MIS) that has also had the vaccine. Thirty-three-plus million people have been vaccinated so far in the United States and not one of those people have been reported to have this process. Only people who have had the actual infections with SARS-CoV-2 have had this process occur.”

In a report to the Centers for Disease Control in early October, 27 adults in the nation were documented to have had multi-system inflammatory response. Two-thirds were aware they had had COVID. The other one-third had it confirmed in an antibody test.

The other rumor Threlkeld says he wants to dispel is that Williams had some new, resistant form of the virus, such as one of the variants.

“We never recovered virus from him, and that, accompanied by the positive antibodies, suggest that actual infection was at least a few weeks in the past,” he said.

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Threlkeld, other Baptist physicians and the CDC are working to be sure there is no indication that there is any relationship to the vaccine.

“Once we have more people who have both the infection and the vaccine, you’re going to see people who had both,” he said.

Threlkeld spoke with the permission of Williams’ family, who wanted to set the facts straight.

“They are very keen to get this right, to be sure we report this accurately and we try to save other lives because that is what he would want to do,” he said.

“He was a prince of a guy. He was well-liked and well-respected by all his colleagues,” Threlkeld said. 

Williams had just gotten married in December.

“It is a particular tragedy in a year of a lot of terrible tragedies,” Threlkeld said. “I have great respect for the family who wanted us to be sure the truth is out there.

“This is not a reason to not get the vaccine. This is a reason to get the vaccine. Only people who have had COVID-19 have developed this life-threatening process.”