Abstract
While the number of people who have been vaccinated against coronavirus disease 2019 (COVID-19) in Portugal keeps rising, the risk of complications, although rare, keeps rising too. We report a case of vaccine-induced thrombotic thrombocytopenia (VITT) in a 30-year-old previously healthy male after vaccination with Ad26.COV2.S. The patient presented to the emergency department (ED) with abdominal pain and headache. Laboratory tests revealed thrombocytopenia, high D-dimer levels, and fibrinogen consumption. Thoracoabdominal CT scan showed a thrombus in the portal mesenteric venous axis. A positive PF4 heparin enzyme-linked immunosorbent assay confirmed the VITT diagnosis, and the patient was started on intravenous immunoglobulin. Both clinical complaints and laboratory findings resolved within six days, and he was discharged to follow-up. This case shows that general symptoms after vaccination should not be depreciated, highlights the importance of early diagnosis and treatment, and raises new questions about the follow-up and further study of these patients.
Highlights
The coronavirus disease 2019 (COVID-19) pandemic has a global impact affecting healthcare systems [1]
The vaccination rate increased extremely fast around the world, and the first vaccine-induced thrombotic thrombocytopenia (VITT) cases associated with the ChAdOx1 nCoV-19 (AstraZeneca) vaccine were described in February 2021 [3]
We reported a VITT case after the adenovirus 26 (Ad26).COV2.S vaccine admitted in an intermediate care unit (IMU) in August 2021
Summary
The coronavirus disease 2019 (COVID-19) pandemic has a global impact affecting healthcare systems [1]. A 30-year-old male patient presented in the emergency department (ED) with abdominal pain and headache. He had been vaccinated against COVID-19 with the Ad26.COV2.S vaccine 19 days prior. In the two days, he complained of fatigue Eight days later, he presented with fever and headache, for which he took ibuprofen, and on the 12th day, his main complaint was sudden-onset abdominal pain that would not resolve with medication. He presented with fever and headache, for which he took ibuprofen, and on the 12th day, his main complaint was sudden-onset abdominal pain that would not resolve with medication As symptoms persisted, he came to the ED. The patient had no past medical history and no chronic medication He had no neurological deficit, fever, or respiratory insufficiency. Reverse transcription PCR testing via nasopharyngeal swab returned negative for COVID-19
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