Index Entries

Safi Ur Rehman Daim, Aya Alsermani, Renad Khalid Althomali, Muhammad Fawad Ashraf, and Maamoun AlSermani
July 13, 2024
Radiology Case Reports

"Case presentation

A 26-year-old Saudi female with no history of any medical issue presented with a 4-day history of shortness of breath, minimal excretion, and palpitation associated with pre-syncope and non-radiating chest pain. She had no history of trauma, surgery, cellulitis, lifting heavy weights, hormonal injections, or contraceptives. 

The patient received the COVID-19, mRNA-type (Pfizer) vaccine second dose 4 days before her presentation. She received the first dose in May 2021 and the second dose in September 2021. Four days after the second dose, she presented to the Emergency Department... She did not have any medical condition and was in perfect state of health before her recent presentation ... 

On suspicion of pulmonary embolism [PE], a chest CT scan was done and showed extensive pulmonary embolism. Radiology department reported the following findings; 'Extensive bilateral PE seen involving bilateral main pulmonary divisions extending to bilateral lobar and segmental branches, mainly middle and lower segments' ... 

Discussion

... Vaccination became the foundation of the fight against COVID-19... Following mass production and administration of these vaccines, surveillance revealed some rare serious adverse effects not initially encountered in clinical trials. Among these adverse effects, thromboembolism was the most serious one.

Most of the reported thromboembolism cases following COVID-19 vaccine administration have been with viral-based vector vaccines. Mechanisms to explain this have been hypothesized. For Viral based vector vaccines, negatively charged polyadenylated hexone proteins mimicking heparin to induce a conformational change in PF-4 and the formation of antibodies against it is the preeminent theory. Impurities in the vaccine, intrinsic acquired or inherited factors like pre-priming of B cells, or differences in T cells enhance this effect and lead to the development of thromboembolism in the affected individuals while unaffected vaccinated individuals don't develop these side effects in the absence of these factors."
document
adverse events,clinical cases,COVID-19,vaccines,vascular system issues