Terms of Use. The median age was 50 y (range, 2396y), and 80% were women. Sign In to Email Alerts with your Email Address. Complications from COVID-19 vaccines have yet to be sufficiently analyzed because they are rapidly approved without long-term data. A few case studies have reported people admitted to the hospital with leukemia shortly after developing COVID-19. 2021 Aug;33(8):922-926. doi: 10.3760/cma.j.cn121430-20201231-00788. Herein, we report a patient who underwent transient lymphedema after vaccination with BNT16b2. Absolute lymphocyte count; COVID-19; Coronavirus; Lymphopenia. Readers were masked and did not know the patients characteristics. The literature has characterized the outcomes of myocarditis following COVID-19 infection and vaccination, but clinicopathologic, hemodynamic, and pathologic Conclusion: Knowing the sensitivity of absolute lymphocyte count in patients with COVID-19 may help identify patients who are unlikely to have the disease. J Neurol Sci 2021;428:117607. Previous studies determined a low lymphocyte count is commonly found in patients with COVID-19. -, Sahin U, Muik A, Derhovanessian E, et al. Lymphopenia is frequently linked to a worsening of clinical symptoms and an increased risk of death in COVID-19. For ALC, we used the lower limit of normal for each center. COVID -19 vaccines are also associated with cytopenias of varying degrees. doi: 10.7759/cureus.28953. -, Guan W.-J., Ni Z.-Y., Hu Y., et al. Bethesda, MD 20894, Web Policies 2021 Feb 16;12:581469. doi: 10.3389/fimmu.2021.581469. The body keeps a few T-lymphocytes, called memory cells, that go into action quickly if the body encounters the same virus again. Six of the cases had been histologically documented by fine-needle aspiration cytology (n = 3) or sentinel lymph node biopsy (n = 3). FDG PET/CT radiomics as a tool to differentiate between reactive axillary lymphadenopathy following COVID-19 vaccination and metastatic breast cancer axillary lymphadenopathy: a pilot study. Lymphopenia is frequently linked to a worsening of clinical symptoms and an increased risk of death in COVID-19. An age of no more than 50 y (odds ratio [OR], 2.2; 95% CI, 1.04.5), the absence of lymphopenia (OR, 2.2; 95% CI, 1.14.3), and a less than 30-d interval from the last vaccine injection to the date of 18F-FDG PET/CT (OR, 2.6; 95% CI, 1.35.6) were statistically significant factors associated with v-HLNs (Fig. Published by Wolters Kluwer Health, Inc. A Rare Occurrence of Opportunistic Infection by Streptococcus mitis Due to Antibiotic-Induced Neu Alabama College of Osteopathic Medicine Research, Baylor Scott & White Medical Center Department of Neurosurgery, California Institute of Behavioral Neurosciences & Psychology, Contemporary Reviews in Neurology and Neurosurgery, DMIMS School of Epidemiology and Public Health, Simulation, Biodesign, & Innovation In Medical Education, The Florida Medical Student Research Publications, University of Florida-Jacksonville Neurosurgery, VCOM Clinical, Biomedical, and Educational Research, American Red Cross Scientific Advisory Council, Canadian Association of Radiation Oncology, International Liaison Committee on Resuscitation, International Pediatric Simulation Society, Medical Society of Delaware Academic Channel, Society for Healthcare & Research Development, Surgically Targeted Radiation Therapy for Brain Tumors: Clinical Case Review, Clinical and Economic Benefits of Autologous Epidermal Grafting, Defining Health in the Era of Value-Based Care, Optimization Strategies for Organ Donation and Utilization, MR-Guided Radiation Therapy: Clinical Applications & Experiences, Multiple Brain Metastases: Exceptional Outcomes from Stereotactic Radiosurgery, Proton Therapy: Advanced Applications for the Most Challenging Cases, Radiation Therapy as a Modality to Create Abscopal Effects: Current and Future Practices, Clinical Applications and Benefits Using Closed-Incision Negative Pressure Therapy for Incision and Surrounding Soft Tissue Management, Negative Pressure Wound Therapy with Instillation, NPWT with Instillation and Dwell: Clinical Results in Cleansing and Removal of Infectious Material with Novel Dressings. 8600 Rockville Pike The literature has characterized the outcomes of myocarditis following COVID-19 infection and vaccination, but clinicopathologic, hemodynamic, and pathologic Patient concerns: Therefore, it is possible that a person could be infected with the virus that causes COVID-19 just before or just after vaccination and then get sick because the vaccine did not have enough time to provide protection. We have shown that patient age (50 y), ALC (
lower limit of normal). We aimed to predict the presence of vaccine-induced hypermetabolic lymph nodes (v-HLNs) on 18F-FDG PET/CT after coronavirus disease 2019 (COVID-19) vaccination and determine their association with lymphocyte counts. However, reliably identifying patients with COVID-19 in the emergency department before hospital admission is often limited by the speed and availability of testing. QUESTION: Can we use ALC to predict the presence of v-HLNs in the drainage territory on 18F-FDG PET/CT after COVID-19 vaccination? Steroids such as Prednisolone have a very short-lived effect of increasing the neutrophils. Parameters Associated with v-HLNs in Whole Cohort (260 Patients) on Univariate and Multivariate Logistic Regression Analyses. doi: 10.1371/journal.pone.0254073. Wagner J, DuPont A, Larson S, Cash B, Farooq A. Int J Lab Hematol. Zhang JJ, Cao YY, Tan G, Dong X, Wang BC, Lin J, Yan YQ, Liu GH, Akdis M, Akdis CA, Gao YD. Superficial venous thrombosisas a possible consequence of ChAdOx1 nCoV-19 vaccine: two case reports. Viruses. government site. Clinical Characteristics, Complications, and Predictors of Poor Outcome Among Hospitalized Adult COVID-19 Patients: A Retrospective Cohort Study. Tabbakh TA, Alhashemi HH, Alharbi K, Qanash S, Alzahrani MS, Saati A, Alsulami S, Alsulami A, Neyazi A, Alzahrani A, Taher ZA, Aljedaani G, Alhejaili A. Cureus. Background: Myocarditis, diagnosed by symptoms and troponin elevation, has been well-described with COVID-19 infection, as well as shortly after COVID-19 vaccination. eCollection 2022. On the basis of lymphoscintigraphy, the patient was diagnosed with transient lymphedema with decreased lymphatic transport in both lower extremities. -, Sharifian-Dorche M, Bahmanyar M, Sharifian-Dorche A, et al. The body keeps a few T-lymphocytes, called memory cells, that go into action quickly if the body encounters the same virus again. . Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. doi: 10.1097/MD.0000000000026503. Chung JH, Hwang YJ, Park SH, Yoon ES. eCollection 2022 Dec. Aimo C, Mariotti EB, Corr A, Quintarelli L, Bianchi B, Verdelli A, Ruffo di Calabria V, Caproni M. Vaccines (Basel). eCollection 2022. Polack FP, Thomas SJ, Kitchin N, et al. 2022 Sep 1;6(1):17. doi: 10.1186/s41824-022-00138-1. Diagnosis: We identified 7 BC patients who had axillary HLNs ipsilateral to the recently vaccinated arm but also ipsilateral to the known tumor. Patients were then screened, and we focused on 145 severe cases and 60 critical cases (29 recovered cases, 31 deaths). Eifer M, Pinian H, Klang E, Alhoubani Y, Kanana N, Tau N, Davidson T, Konen E, Catalano OA, Eshet Y, Domachevsky L. Eur Radiol. Clinical photograph of patient. Although continuing lymphoma therapy, she received 2 mRNA COVID-19 vaccine injections in right deltoid. sharing sensitive information, make sure youre on a federal Kang MK, Lee YR, Song JE, Kweon YO, Tak WY, Jang SY, Park JG, Park SY. WebA reduced peripheral blood absolute lymphocyte count with an elevated neutrophil count has been a consistent observation in hospitalized coronavirus disease 2019 (COVID-19) patients. In this study, ALC correlated with a higher seropositivity likelihood and antibody titers. However, its not clear if COVID-19 played a role or how much of a role it played. We also divided critical patients into group A (<1.1 109/L) and group B (>1.1 109/L) according to number of lymphocytes. 2021 May 1;46(5):396-401. doi: 10.1097/RLU.0000000000003648. KEYWORDS 18F -FDG PET/CT; COVID 19 vaccination; absolute lymphocyte count; hypermetabolic lymph nodes; immune response. However, the survival rate according to lymphocyte levels in group A was significantly lower than that of group B at 25% hospital stay (on average day 6.5), 50% and 75% time points (P < .001).Lymphocyte counts that remain lower after the first week following symptom onset are highly predictive of in-hospital death of adults with COVID-19. Careers. 2021;397:99111. FOIA We conducted a retrospective review of 702 consecutive patients who underwent 18F-FDG PET/CT imaging at Institut Curie Hospital, Saint-Cloud, France (the flow chart is provided in Fig. Zhang J, Wang Z, Wang X, Hu Z, Yang C, Lei P. Front Immunol. . WebIn breast cancer patients, the absence of lymphopenia was the only independent factor significantly associated with v-HLNs (OR, 2.9; 95% CI, 1.2-7.4). -, Baden LR, El Sahly HM, Essink B, et al. Methods: This is a prognostic study that is conducted from March 1 to August 31, 2020. A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients. Axillary lymph node characteristics in breast cancer patients versus post-COVID-19 vaccination: Overview of current evidence per imaging modality. A recent Johns Hopkins Medicine study suggests that T lymphocytes immune system cells that target the spike protein and direct antibodies against the COVID-19 virus persist six months after vaccination In particular, there are no case reports of lymphedema in a healthy patient following vaccination. This study aimed to determine the role of lymphocyte levels in predicting COVID-19 patient mortality. Lymphocyte subsets as a predictor of severity and prognosis in COVID-19 patients. Epub 2020 Aug 24. Federal government websites often end in .gov or .mil. Obesity as a potential predictor of disease severity in young COVID-19 patients: a retrospective study. Clipboard, Search History, and several other advanced features are temporarily unavailable. It typically takes a few weeks after vaccination for the body to produce T-lymphocytes and B-lymphocytes. Lymphopenia also has a 4.35-fold increase in the risk of mortality. 2020;53:724732.e7. Lymphopenia is frequently linked to a worsening of clinical symptoms and an increased risk of death in COVID-19. 2023 Feb;118:53-64.e1. The lymphocyte count in dead patients was significantly lower than that of critical recovered cases, at almost every time point in the critical groups (D). -. Furthermore, the patient was trained to apply a multilayer compressive bandage to the lower extremities. Conclusion: Hippisley-Cox J, Patone M, Mei XW, Saatci D, Dixon S, Khunti K, Zaccardi F, Watkinson P, Shankar-Hari M, Doidge J, Harrison DA, Griffin SJ, Sheikh A, Coupland CAC. In contrast, the researchers discovered that a form of white blood cells (leukocytes) called lymphocytes showed decreased stiffness in COVID-19 patients, while other white blood cells, known as monocytes, were significantly larger than in eCollection 2022 Sep. See this image and copyright information in PMC, Abstracts of Presentations at the Association of Clinical Scientists 143. The length of hospitalization was divided into five time points, namely admission, 25%, 50%, 75% and discharge or death, according to the principle of interquartile distance. 2022 May;52(3):511-525. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The absolute lymphocyte count for these patients was used to calculate sensitivities at various cut-off values. Exp Hematol. All these parameters are closely related to the humoral immune response; however, as stated by the authors of the previously cited studies, the role of lymphocytes in cell-mediated immune response after COVID-19 vaccination remains to be investigated. COVID -19 vaccines are also associated with cytopenias of varying degrees. Demographics, clinical parameters, and absolute lymphocyte count (ALC) were collected, and their association with the presence of v-HLNs in the draining territory was studied by logistic regression. Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19) Int J Infect Dis. Lancet. (A) A 79-year-old woman manifested bilateral lower extremity swelling 1 week after COVID-19 vaccination. Alfadda AA, Rafiullah M, Alkhowaiter M, Alotaibi N, Alzahrani M, Binkhamis K, Siddiqui K, Youssef A, Altalhi H, Almaghlouth I, Alarifi M, Albanyan S, Alosaimi MF, Isnani A, Nawaz SS, Alayed K. Front Med (Lausanne). Other effects of body weakening can also be associated with vaccines. Montiel-Cervantes LA, Medina G, Pilar Cruz-Domnguez M, Prez-Tapia SM, Jimnez-Martnez MC, Arrieta-Oliva HI, Carballo-Uicab G, Lpez-Pelcastre L, Camacho-Sandoval R. Nie L, Liu Y, Weng Y, Zheng Y, Cai L, Kou G, Xiong Z, Liu L. Int J Lab Hematol. Through survival analysis, we found that there was no significant difference in survival between group A and group B at admission (P = .3065). Before . More than half the patients were referred for BC (56%), and 24% were considered immunosuppressed (n = 62). We do not capture any email address. 2020 May 29;369:m1996. government site. However, ultrasonographic findings revealed no evidence of venous thrombosis or varicose veins. 3), all sentinel lymph node biopsies revealed benign reactive changes (43%) (Fig. The https:// ensures that you are connecting to the 4). and transmitted securely. Family doctors, hematologists, breast surgeons, and radiologists must be aware of the fact that axillary, lower neck, supraclavicular, and infraclavicular lymphadenopathy may be related to the COVID-19 vaccine rather than representing actual more sinister pathologic processes. Indeed, BC patients with a normal value of ALC were more likely to have v-HLNs on 18F-FDG PET/CT. Table 1 summarizes the detailed demographic and clinicobiologic characteristics and PET imaging parameters of the 145 BC patients. Epub 2022 Nov 28. The median age was 50 y (range, 23-96 y). Clinical data consisted of the patients age, sex, disease (cancer type if applicable), and current specific treatment (chemotherapy, endocrine therapy, immunotherapy with immune checkpoint inhibitors, or targeted therapy). Prognostic Impact of Myosteatosis on Mortality in Hospitalized Patients with COVID-19. Among BC patients, v-HLNs in the axillary area and beyond can mimic tumor lesions and lead to confounding of imaging results (16). It is not related to whether the EBV is still present in your body. Accessibility https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technica Naming the coronavirus disease (COVID-19) and the virus that causes it. Please enable it to take advantage of the complete set of features! (B) Lymphoscintigraphy showed a decreased lymphatic transport in both lower extremities, especially on the left side. License: https://creativecommons.org/licenses/by/4.0/. . Lymphedema of the Arm after COVID-19 Vaccination in a Patient with Hidden Breast Cancer and Paraneoplastic Dermatomyositis. Their demographic characteristics, vaccination information, 18F-FDG PET/CT parameters, ALC, and histologic data are reported in Table 4. Lymphopenia plays an important role in estimating COVID-19 patient mortality. Details: http://jnm.snmjournals.org/site/misc/permission.xhtml. 2020;382(18):17081720. In breast cancer patients, the absence of lymphopenia was the only independent factor significantly associated with v-HLNs (OR, 2.9; 95% CI, 1.27.4). CR = complete response; DLBCL = diffuse large B-cell lymphoma. doi: 10.1016/j.exphem.2022.11.006. . Whole blood counts were available for 106 BC patients after vaccination and before PET. "Never doubt that a small group of thoughtful, committed citizens can change the world. However, efficient indicators for disease severity have not been fully investigated. Results: Methods: 2022 Jan 1;399(10319):36-49. doi: 10.1016/S0140-6736(21)02718-5. A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients. This site needs JavaScript to work properly. An official website of the United States government. See this image and copyright information in PMC. Family doctors, hematologists, breast surgeons, and radiologists must be aware of the fact that axillary, lower neck, supraclavicular, and infraclavicular lymphadenopathy may be related to the COVID-19 vaccine rather than representing actual more sinister pathologic processes. Gneysu F, Guner NG, Erdem AF, Durmus E, Durgun Y, Yurumez Y. J Coll Physicians Surg Pak. Careers. -, Grada AA, Phillips TJ. 2021 Aug 26;374:n1931. Yu Q, Jiang W, Chen N, Li J, Wang X, Li M, Wang D, Jiang L. Front Immunol. This predictor may help clinicians identify patients with a poor prognosis and may be useful for guiding clinical decision-making at an early stage. The https:// ensures that you are connecting to the Eur J Radiol. Accessibility . Epub 2022 Apr 6. The size of most HLNs was recorded using short-axis diameter on CT images. Lancet. Further prospective studies are warranted to investigate whether the metabolism of lymphoid organs on 18F-FDG PET/CT is a crucial effector of the immune response after COVID-19 vaccination. In the absence of clinical evidence of swelling during the laboratory evaluation, we suspected deep vein thrombosis. Clipboard, Search History, and several other advanced features are temporarily unavailable. Clinical and biochemical characteristics of people experiencing post-coronavirus disease 2019-related symptoms: A prospective follow-up investigation. The patients age and immune status, the type of vaccine, the number of doses, or the interval from the last vaccine injection to the date of 18F-FDG PET/CT were not significantly associated with v-HLNs in this subgroup of BC patients. Kang MK, Lee YR, Song JE, Kweon YO, Tak WY, Jang SY, Park JG, Park SY. As previously published by Thomassen etal. doi: 10.1080/2000656X.2021.1964980. Keywords: HHS Vulnerability Disclosure, Help Moreover, only 10% of patients received the viral vectorbased COVID-19 vaccine. COVID-19 and venous thromboembolism: a meta-analysis of literature studies. Zhang HJ, Qi GQ, Gu X, Zhang XY, Fang YF, Jiang H, Zhao YJ. Neck circumference as reliable predictor of mechanical ventilation support in adult inpatients with COVID-19: a multicentric prospective evaluation. . Clinical and biochemical characteristics of people experiencing post-coronavirus disease 2019-related symptoms: A prospective follow-up investigation. Epub 2022 Apr 30. Diagnostics (Basel). The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Factors associated with v-HLNs were tested by logistic regression analysis using a stepwise Akaike information criterion method for variable selection (26). Copyright 2021 the Author(s). Would you like email updates of new search results? Risk Factors for Mortality of COVID-19 Patient Based on Clinical Course: A Single Center Retrospective Case-Control Study. 2022 Jul;152:110334. doi: 10.1016/j.ejrad.2022.110334. The messenger RNA vaccine had been given to 233 (90%). Where there was any uncertainty about HLN etiology (disease-related or vaccine-induced), we categorized the patients into an indeterminate-HLN group. Rationale: Complications from COVID-19 vaccines have yet to be sufficiently analyzed because they are rapidly approved without long-term data. The authors have no potential conflicts of interest relevant to this article to report. A retrospective chart review was performed on 312 patients with laboratory-confirmed COVID-19 who were admitted to the hospital from the emergency department. 2022 Sep;32(9):5921-5929. doi: 10.1007/s00330-022-08725-3. Kilercik M, Demirelce , Serdar MA, Mikailova P, Serteser M. PLoS One. Four hundred forty-two patients were not vaccinated (n = 437) or did not want to participate in medical research (n = 5) and were excluded. Additionally, lower mean absolute lymphocyte counts were identified in males, patients who required intubation, and patients who died. World Health Organization; 2021. Amoo OS, Onyia N, Onuigbo TI, Vitalis SU, Davies-Bolorunduro OF, Oraegbu JI, Adeniji ET, Obi JC, Abodunrin ON, Ikemefuna AS, Adegbola RA, Audu RA, Salako BL. Indeed, this sex bias in favor of women is due to the nature of our center, which is a referral one for BC treatment. Would you like email updates of new search results? Such vaccination has been shown to promote immunity against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by inducing strong T- and memory B-cell responses (4,5). Patients fasted for at least 6 h before scanning to ensure a blood glucose level of less than 10mmol/L. 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