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Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination

As the coronavirus disease 2019 (COVID-19) global pandemic continues, multiple vaccines have been developed to decrease infection rate and number of deaths. Vaccine administration is especially important as new COVID-19 variants emerge. While the number of severe thromboembolic events reported after...

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Autores principales: Valle, Ana, Levy, Rachel, Tobias, Abraham, Friedman, Ellen, Hassan, Iman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299835/
https://www.ncbi.nlm.nih.gov/pubmed/37384077
http://dx.doi.org/10.7759/cureus.39609
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author Valle, Ana
Levy, Rachel
Tobias, Abraham
Friedman, Ellen
Hassan, Iman
author_facet Valle, Ana
Levy, Rachel
Tobias, Abraham
Friedman, Ellen
Hassan, Iman
author_sort Valle, Ana
collection PubMed
description As the coronavirus disease 2019 (COVID-19) global pandemic continues, multiple vaccines have been developed to decrease infection rate and number of deaths. Vaccine administration is especially important as new COVID-19 variants emerge. While the number of severe thromboembolic events reported after adenovirus-based vaccination has gained attention, there is little information regarding the presentation and management of post-vaccination venous thromboembolism (VTE). Here, we present two cases of VTE after the Janssen vaccine administration. In the first case, a 98-year-old African American female with hypertension developed bilateral lower extremity edema that evolved into unilateral lower extremity edema 20-35 days following the Janssen vaccine administration. She was found to have an extensive unilateral proximal femoral deep vein thrombosis (DVT) 35 days after the vaccination. In the second case, a 64-year-old African American female developed ecchymosis and unilateral edema six days after the Janssen vaccine administration. She was found to have proximal superficial vein thrombosis two days later. In both cases, laboratory data, including platelets and anti-heparin antibodies were within normal limits. Thus, VTE may be an adverse effect of the Janssen vaccine or any adenovirus-based vaccine, but further surveillance and investigation to elucidate this association are necessary. We advise practitioners to have a high index of suspicion for thrombosis after Janssen vaccine administration, regardless of the presence of thrombocytopenia, and avoidance of heparin products until heparin antibody results return. 
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spelling pubmed-102998352023-06-28 Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination Valle, Ana Levy, Rachel Tobias, Abraham Friedman, Ellen Hassan, Iman Cureus Internal Medicine As the coronavirus disease 2019 (COVID-19) global pandemic continues, multiple vaccines have been developed to decrease infection rate and number of deaths. Vaccine administration is especially important as new COVID-19 variants emerge. While the number of severe thromboembolic events reported after adenovirus-based vaccination has gained attention, there is little information regarding the presentation and management of post-vaccination venous thromboembolism (VTE). Here, we present two cases of VTE after the Janssen vaccine administration. In the first case, a 98-year-old African American female with hypertension developed bilateral lower extremity edema that evolved into unilateral lower extremity edema 20-35 days following the Janssen vaccine administration. She was found to have an extensive unilateral proximal femoral deep vein thrombosis (DVT) 35 days after the vaccination. In the second case, a 64-year-old African American female developed ecchymosis and unilateral edema six days after the Janssen vaccine administration. She was found to have proximal superficial vein thrombosis two days later. In both cases, laboratory data, including platelets and anti-heparin antibodies were within normal limits. Thus, VTE may be an adverse effect of the Janssen vaccine or any adenovirus-based vaccine, but further surveillance and investigation to elucidate this association are necessary. We advise practitioners to have a high index of suspicion for thrombosis after Janssen vaccine administration, regardless of the presence of thrombocytopenia, and avoidance of heparin products until heparin antibody results return.  Cureus 2023-05-28 /pmc/articles/PMC10299835/ /pubmed/37384077 http://dx.doi.org/10.7759/cureus.39609 Text en Copyright © 2023, Valle et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Internal Medicine
Valle, Ana
Levy, Rachel
Tobias, Abraham
Friedman, Ellen
Hassan, Iman
Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination
title Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination
title_full Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination
title_fullStr Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination
title_full_unstemmed Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination
title_short Two Cases of Venous Thromboembolism Shortly After Adenovirus-Based COVID-19 Vaccination
title_sort two cases of venous thromboembolism shortly after adenovirus-based covid-19 vaccination
topic Internal Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10299835/
https://www.ncbi.nlm.nih.gov/pubmed/37384077
http://dx.doi.org/10.7759/cureus.39609
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