COVID-19 Vaccination Associated Bilateral Pulmonary Embolism: Cause or Coincidence

BACKGROUND: Acute pulmonary embolism (APE) is a common cause of morbidity and mortality all over the world. Sudden onset dyspnea and chest pain are characteristic. Prior to our index case, only two previous cases of bilateral pulmonary thromboembolism were reported in black Africans and the first to be associated with COVID-19 vaccination. These cases were seen and described in middle-aged men. Case Summary. A 59-year-old man presented with a 2 week history of sudden onset dyspnea and a week history of productive cough. No associated chest pain or hemoptysis. No preceding history suggestive of leg pain/swelling. The patient had the booster dose of moderna (mRNA) COVID-19 vaccine a month before the onset of symptoms. There was associated anorexia, generalized body pain, joint pain, and weakness. He had reduced oxygen saturation at presentation with tachycardia. CTPA showed nearly occlusive right and left pulmonary arteries. CONCLUSION: Bilateral acute pulmonary embolism is rare all over the world. Its association with COVID-19 vaccine administration is even rarer. However, the clinical presentations and investigation findings are similar to the descriptions available in the literature for unilateral APE.