A CASE OF PULMONARY THROMOEMBOLISM OCCURRED IMMEDIATELY AFTER THE FIRST DOSE OF CHADOX1 NCOV- 19 VACCINATION.

Abstract

In the recent studies, COVID-19 vaccines, especially Covishield has been associated with the reports of Vaccine-Induced pulmonary thromboembolism. pulmonary thromboembolism is a complication that can occur after the rst dose of the vaccine causing the thrombosis in veins at specic sites like lungs, Brain and Deep Veins and Arteries. It presents commonly as the Pulmonary Embolism (PE), within 7-10 days of vaccination. Patients taking vaccinations under the age of 45 presents at the high risk. Mortality rate in such post vaccination thrombosis is considered to be 50% in some cases. Thus, it is far more important to understand and identify the early signs and symptoms for early diagnosis, proper treatment and interventions. In the following case presented. A 29-year-old male patient was presented with the complaints of High Fever, Cough and Extreme Breathlessness after receiving the rst dose of ChADOx1 nCoV-19 Vaccination against the Corona Virus Disease 2019 (COVID-19). He had history of Exertional Dyspnoea for 2-3 weeks. He was diagnosed to have Pulmonary Embolism with severe PAH. 2D ECHO was done which showed Severe Pulmonary Hypertension Likely Pulmonary Thromboembolism, Good biventricular systolic function, Mild TR. CT Chest with Pulmonary Angiography was done which showed Eccentric lling defect seen in bilateral arteries at hila with extension in lower lobe segment branches- likely thrombus. CT Scan of Thorax (Plain & Contrast) was also done which showed bilateral small patchy ground glass haze with superimposed Reticular thickening mainly in Subpleural region. He was immediately thrombolysed with Intrapulmonary TNK after doing Check angiography. He was then managed with Oxygen support, NIV support, Inj. Fondaparinux, Anti biotics, Anti-coagulant, diuretics, Pulmonary vasodilators, Anti-hypertensive, and other supportive drugs. He responded well to the given treatment and was gradually weaned off NIV and oxygen support. Serial D-dimer, CBC, Chest X ray monitoring was done. Repeat CT chest was done in view of fresh lesions on Chest X ray which showed cavitatory lesion in Right mid zone with moderate Pleural effusion. Chest Physician consultation was taken and advice followed accordingly. He was discharged after 19 days, later he was then taken up for follow up every 2 weeks