Journal Article

Unilateral axillary adenopathy induced by COVID-19 vaccine: US follow-up evaluation

Fernández-Montero, Alejandro, Elizalde, Arlette, Quan, Paola Leonor, Pina, Luis, Igual-Rouilleault, Alba Cristina, Soriano, Ignacio

2022

Overview

Objectives This study was conducted in order to investigate COVID-19 vaccine influence on unilateral axillary lymph nodes, comparing nodal basal features with their characteristics after the first and second vaccination dose. Methods Ninety-one volunteer employees from our center who participated in the BNT162b2 (Pfizer-BioNTech) vaccination campaign were prospectively recruited. A total of three axillary ultrasound evaluations of the ipsilateral vaccinated arm were performed: before vaccination, the week after the first dose and the week after the second dose. The following findings were recorded: the total number of visible nodes, the maximum measurements of the diameter and cortex, Bedi’s classification, and color Doppler evaluation. The collected data were compared using paired-sample Student’s t -test for quantitative continuous variables and Wilcoxon rank-sum test for ordinal variables. Additional analyses were performed after classifying patients according to the previous history of COVID-19 disease. Differences among both groups were evaluated with the Mann–Whitney U test. Variables with a p value < 0.05 were considered statistically significant. Results Comparative analyses between the three US examinations showed a statistically significant augmentation of total visible nodes, maximum diameter, cortical thickness, grade of Bedi’s classification, and Doppler signal ( p  < 0.001). Analyses between patients with and without previous COVID-19 infection showed a higher lymph node response in naïve patients compared to those who were previously infected. Conclusions According to our results, both doses of COVID-19 vaccine induced an increase of all axillary lymph node parameters with statistically significant differences, especially in coronavirus-naïve patients. Key Points • Pfizer COVID-19 vaccine induces a high incidence of ipsilateral axillary lymphadenopathy. • US scan identified an increase of all lymph nodes parameters, especially in coronavirus-naïve patients.

• Publisher: Springer Berlin Heidelberg,Springer Nature B.V
• Subject: BNT162 Vaccine / Breast / Classification / Comparative analysis / Continuity (mathematics) / Coronaviruses / COVID-19 - prevention & control / COVID-19 vaccines / COVID-19 Vaccines - adverse effects / Diagnostic Radiology / Diameters / Evaluation / Follow-Up Studies / Humans / Imaging / Immunization / Internal Medicine / Interventional Radiology / Lymph nodes / Lymphadenopathy / Lymphadenopathy - diagnostic imaging / Lymphadenopathy - etiology / Lymphatic system / Medicine / Medicine & Public Health / Neuroradiology / Parameter identification / Quality / Radiology / SARS-CoV-2 / Signal classification / Statistical analysis / Ultrasound / Vaccination / Vaccines / Viral diseases