Association of COVID-19 vaccine with lymph node reactivity: an ultrasound-based study

Yıl 2022, Cilt: 5 Sayı: 5, 1390 - 1393, 25.09.2022

Belma Çevik

https://doi.org/10.32322/jhsm.1123597

Öz

Aim: Millions of people worldwide have been infected and died due to the pandemic caused by COVID-19. Vaccination is the most effective way to deal with the pandemic. Though vaccines are safe, they are not completely risk-free, and some side effects can occur after vaccination such as lymphadenopathy. This study, it was aimed to measure the lymph node reactivity that may develop after mRNA vaccination.
Material and Method: A total of 50 healthy people were included in the study. Left axillary and supraclavicular ultrasound examinations were performed before and one week after the administration of the mRNA vaccine. Each patient was assessed for supraclavicular and level 1 axillary lymph region in terms of the presence, size (long and short axis), and cortex thickness of the lymph nodes.
Results: Of the patients participating in the study, 23 (46 %) were male, 27 (54 %) were female, and the median age was 33. In comparison, the difference in long, short axis and cortex diameter measurements of the supraclavicular lymph node before and after vaccination was found to be statistically significant (p=0.034, 0.021, 0.004, respectively). Similarly, the difference in the long, short axis, and cortex thickness of the left axillary lymph node before and after vaccination was statistically significant (p<0.001, <0.001, <0.001, respectively).
Conclusion: Anti-Covid-19 vaccines may cause lymphadenopathy as a result of reactivation in lymph nodes in the left axillary and supraclavicular regions. When lymphadenopathy is detected in these regions, the vaccine should be questioned in the clinical history and ultrasound follow-up should be performed on the patient.

Anahtar Kelimeler

Lymphadenopathy, COVID-19 vaccines, ultrasound

Teşekkür

I would like to thank Hulya Sirin, MD, for her help with the statistical evaluations.

Kaynakça

• Yazdanpanah F, Hamblin M, Rezaei N.The immune system and COVID-19: Friend or foe? Life Sci 2020; 256117900.
• Huang Q, Zeng J, Yan J. COVID-19 mRNA vaccines. J Genet Genomics 2021; 48: 107-14.
• Tu W, Gierada DS, Joe BN. COVID-19 Vaccination-related lymphadenopathy: what to be aware of. Radiol Imaging Cancer 2021; 3: e210038.
• Cocco G, Pizzi AD, Fabiano S, et al. Lymphadenopathy after the Anti-COVID-19 vaccine: multiparametric ultrasound findings. Biology 2021; 10: 652
• Thompson MG, Burgess JL, Naleway AL, et al. Interim estimates of vaccine effectiveness of BNT162b2 and mRNA-1273 COVID-19 vaccines in preventing SARS-CoV-2 infection among health care personnel, first responders, and other essential and frontline workers—eight U.S. locations, December 2020–March 2021. Morb Mortal Wkly Rep 2021; 70: 495–500.
• Sofia S, Boccatonda A, Montanari M, et al. Thoracic ultrasound and SARS-COVID-19: A pictorial essay. J Ultrasound 2020; 23: 217–21.
• Bshesh K, Khan W, Vattoth AL, et al. Lymphadenopathy post-COVID-19 vaccination with increased FDG uptake may be falsely attributed to oncological disorders: A systematic review.J Med Virol 2022; 94: 1833-45.
• Cui, X.-W, Hocke, M, Jenssen C, et al. Conventional ultrasound for lymph node evaluation, update 2013. Z Gastroenterol 2014; 52: 212–21.
• Granata V, Fusco R, Setola SV, et al. Lymphadenopathy after BNT162b2 Covid‐19 Vaccine: preliminary ultrasound findings. Biol 2021; 10: 214
• Coates EE, Costner PJ, Nason MC, et al. VRC 900 Study Team. Lymph node activation by PET/CT following vaccination with licensed vaccines for human papillomaviruses. Clin Nucl Med 2017; 42: 329-34.
• Garreffa E, Hamad A, O'Sullivan CC, et al. Regional lymphadenopathy following COVID-19 vaccination: literature review and considerations for patient management in breast cancer care.Eur J Cancer 2021; 159: 38–51.
• Hanneman K, Iwanochko RM, Thavendiranathan P. Evolution of lymphadenopathy at PET/MRI after COVID-19 vaccination. Radiology 2021; 299: E282.
• Net JM, Mirpuri TM, Plaza MJ, et al. Resident and fellow education feature: US evaluation of axillary lymph nodes. Radiographics 2014; 34: 1817–8.
• Cocco G, Boccatonda A, D’Ardes D, Galletti S, Schiavone C, Mantle cell lymphoma: From ultrasound examination to histological diagnosis. J. Ultrasound 2018; 21: 339–42.
• Chang W, Jia W, Shi J, Yuan C, Zhang Y, Chen M. Role of elastography in axillary examination of patients with breast cancer. J. Ultrasound Med 2018; 37: 699–07.
• El-Sayed MS, Wechie GN, Low CS, Adesanya O, Rao N, Leung VJ. The incidence and duration of COVID-19 vaccine-related reactive lymphadenopathy on 18F-FDG PET-CT. Clin Med (Lond) 2021; 21: 633-8.
• Johnson BJ, Van Abel KM, Ma DJ, Johnson DR.J 18F-FDG-avid axillary lymph nodes after COVID-19 vaccination. Nucl Med 2021; 62: 1483-84.
• Hagen C, Nowack M, Messerli M, Saro F, Mangold F, Bode PK. Fine needle aspiration in COVID-19 vaccine-associated lymphadenopathy. Swiss Medical Weekly 2021; 151.
• Özütemiz C, Krystosek LA, Church AL, et al. Lymphadenopathy in COVID-19 vaccine recipients: diagnostic dilemma in oncologic patients. Radiology 2021; 300: 296–300.
• Xu G, Lu Y. COVID‐19 mRNA vaccination‐induced lymphadeno-pathy mimics lymphoma progression on FDG PET/CT. ClinNucl Med 2021; 46: 353-54.
• Becker AS, Perez-Johnston R, Chikarmane SA, et al. Multidisciplinary recommendations regarding post-vaccine adenopathy and radiologic imaging: radiology scientific expert panel. Radiology 2021; 300: E323–7.
• Mehta N, Sale R.M, Babagbemi K, et al. Unilateral axillary Adenopathy in the setting of COVID-19 vaccine. Clin. Imaging 2021; 75: 12–5.