COVID-19 Moderna Vaccine and Bilateral Pulmonary Embolism: Case Report

Case Report

Austin Crit Care Case Rep. 2021; 5(3): 1031.

COVID-19 Moderna Vaccine and Bilateral Pulmonary Embolism: Case Report

Yazdanpanah F¹*, Anderson R² and Catevenis J³

¹Internal Medicine Department, University of Maryland Capital Region Medical Center, USA

²Department of Critical Care Medicine, University of Maryland Medical System, USA

³Department of Critical Care Medicine, University of Maryland Capital Region Medical Center, USA

*Corresponding author: Yazdanpanah F, Internal Medicine Department Capital Region Medical Center, 901 Harry S Truman Dr N, Largo, MD, 20774, USA

Received: July 23, 2021; Accepted: August 30, 2021; Published: September 06, 2021


The pandemic of Coronavirus Disease 2019 (COVID-19) has created many problems in the entire world whether the disease itself, whether fighting back with limited treatment options and prevention tools. Owing to the escalating daily death rates from COVID-19, the development of a vaccine against this new disease was quite fast that the first authorized vaccine got approval less than a year after the onset of the pandemic. Data report different side effects of new COVID-19 vaccines including venous and arterial thrombotic events, vaccine-induced prothrombotic immune thrombocytopenia, vaccine-induced thrombosis with thrombocytopenia, and immune thrombocytopenia. Our case report highlights bilateral pulmonary embolism, six days after the first dose of the COVID-19 mRNA vaccine (Moderna) in a healthy gentleman.

Keywords: COVID-19 vaccine; Moderna; mRNA vaccine; Pulmonary embolism; Vaccine side effect; Venous thrombotic event

Case Presentation

A 71-year-old African American gentleman presented initially with a fall and having a generalized weakness six days after taking the first dose of the COVID-19 Moderna vaccine. The patient was on the phone when he fell and hit his head. In the emergency department, the initial complaint of the patient was headache and generalized weakness. The patient stated from 24 hours after taking the first shot of the COVID-19 vaccine he was not feeling good and was dealing with a generalized weakness for the last couple of days. The patient denied loss of consciousness, lightheadedness, dizziness, chest pain, shortness of breath, palpitation, and diaphoresis before or at the time of falling. No recent surgery, trauma, immobilization, straight longdistance trip, and history of cancer was mentioned by the patient. Mast medical history was notable for hyperlipidemia. The patient was not on any medications at home either prescribed or over-thecounter drugs. Social history was unremarkable for tobacco, illicit drug, and alcohol use. Family history was negative for cancers and hypercoagulable states.

On physical exam, the patient was completely alert and oriented (Glasgow Coma Scale 15) with no focal deficits on the neurologic exam, but generally was weak; the heart exam was remarkable for a grade 2/6 systolic flow murmur at the left sternal border; other examination findings were normal.

Initial workup including labs was significant for the mild increase of serial cardiac troponin-T enzyme, slight elevation of D.dimer, and abnormal lipid panel. Complete Blood count (CBC) with the focus on platelet number was within the normal range during admission. Hypercoagulable state profile showed normal findings.

Head CT scan without contrast as a standard post-fall workup revealed small foci (7 x 9 mm) of intraparenchymal hemorrhage within the right frontal subcortical white matter in head Computed Tomography (CT) scan without contrast (Figure 1A). Electrocardiogram was normal except for occasional premature atrial and junctional complexes, no ischemic changes were detected. 2D-Echocardiogram revealed normal left ventricle ejection fraction (LVEF: 55-60%), moderate Right Ventricle (RV) enlargement, moderate Tricuspid Regurgitation (TR) with elevated right ventricle systolic pressure (RVSP: 45mmHg). Lower extremity venous duplex ultrasound documented no Deep Vein Thrombosis (DVT) in lower extremities.