Superficial venous thrombosisas a possible consequence of ChAdOx1 nCoV-19 vaccine: two case reports

Mukesh Kumar Sah; Bishnu Mohan Singh; Puja Sinha; Prerit Devkota; Sudhira Kumari Yadav; John Shrestha; Ashis Shrestha

doi:10.1186/s13256-022-03407-6

Superficial venous thrombosisas a possible consequence of ChAdOx1 nCoV-19 vaccine: two case reports

J Med Case Rep. 2022 May 7;16(1):182. doi: 10.1186/s13256-022-03407-6.

Authors

Mukesh Kumar Sah¹, Bishnu Mohan Singh², Puja Sinha³, Prerit Devkota³, Sudhira Kumari Yadav⁴, John Shrestha², Ashis Shrestha⁵

Affiliations

¹ Department of Emergency Medicine and General Practice, Patan Academy of Health Sciences, Lalitpur, Bagmati Province, Nepal. sahmukeshkumar88@gmail.com.
² Patan Hospital, Lalitpur, Nepal.
³ Department of Emergency Medicine and General Practice, Patan Academy of Health Sciences, Lalitpur, Bagmati Province, Nepal.
⁴ Public Health Expert, Louisiana State University, Shreveport, LA, USA.
⁵ Department of Emergency Medicine and General Practice, Patan Academy of Health Sciences, Lalitpur, Nepal.

Abstract

Background: Many scientists across the world got involved in the race to develop successful anti-SARS-CoV-2 vaccines to overcome COVID-19 pandemic. Among the different vaccines developed against SARS-CoV-2, Covishield was the first vaccine approved for emergency use in Nepal. We report two cases of Superficial Vein Thrombosis (SVT) for the first time in the literature after vaccination with the Chimpanzee Adenovirus-vectored Vaccine (ChAdOx1 nCoV-19 vaccine).

Cases presentation: Two cases, a 24-year-old young Chhetri male and a 62-year-old Chhetri female who have received Covishield (ChAdOx1 nCoV-19) vaccine, developed pain in left calf after 2 weeks and 10 weeks of vaccination, respectively. Both the case belongs to the Chhetri ethnic group of Nepal. The pain became severe on the fourth week of immunization in the first case while the pain was acute and severe on the 10^th week of vaccination in the second case. The first presented to emergency room and second case was referred to the emergency room from Orthopedic Clinic. On evaluation the first patient had normal vitals with no history of fever and swelling yet displayed non-radiating mild to moderate intensity pain localized to left leg below the knee which became aggravated by movements. In the second case however pain was more intense with other characteristics as first case. Both cases had low wells score (< 4). On local examination tenderness was noted on squeezing but other systemic examination findings of the patient were within normal limits in both cases. Among the numerous vaccines used to fight the battle against COVID-19 disease, the ChAdOx1 nCoV-19 vaccine, Covishield, has been widely used in Nepal and India. Apart from other minor side effects, in few cases thromboses have been reported after vaccination of ChAdOx1 nCoV-19, Covishield, vaccine.

Conclusion: These cases reporting Superficial Vein Thrombosis may be an additional adverse effect to the list of adverse events associated with ChAdOx1 nCoV-19, Covishield, vaccine. However, the benefits of the vaccine in breaking the chain of COVID 19 spread are certainly greater than the risk of thromboses.

Keywords: COVID 19; ChAdOx1 nCoV-19; Covishield vaccine; Superficial saphenous vein (SSV); Superficial venous thrombosis (SVT); Venous thrombosis.

Publication types

Case Reports

MeSH terms

Adult
COVID-19* / prevention & control
ChAdOx1 nCoV-19
Drug-Related Side Effects and Adverse Reactions*
Female
Humans
Male
Middle Aged
Pain
Pandemics
SARS-CoV-2
Thrombosis*
Vaccination
Vaccines*
Young Adult

Substances

Vaccines
ChAdOx1 nCoV-19