Lymphadenopathy Following COVID-19 Vaccination: Imaging Findings Review

Acad Radiol. 2021 Aug;28(8):1058-1071. doi: 10.1016/j.acra.2021.04.007. Epub 2021 May 1.

Abstract

Rationale and objectives: Despite all the benefits and effectiveness of the coronavirus disease 2019 (COVID-19) vaccines mentioned in recent clinical trials, some post-vaccination side effects such as lymphadenopathy (LAP) were observed. The present study reviewed all studies with imaging findings presentation of LAP after COVID-19 vaccination.

Materials and methods: We conducted a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), Cochrane library, and Google Scholar.

Results: A total of 19 studies (68 cases), including 60 (88.2%) females and eight (11.8%) males with a presentation of LAP after COVID-19 vaccination, were reviewed. LAP was identified after first or second dosages of three types of COVID-19 vaccines, including Pfizer-BioNTech (n = 30, 44.1%), Moderna (n = 17, 25%), and Oxford-AstraZeneca (n = 1, 1.5%). In 20 (29.4%) cases, vaccine type was not reported or only reported as mRNA COVID-19 vaccine. The median days of LAP presentation after the first and second dosages of COVID-19 vaccination, were 12 and 5 days, respectively. Most of the LAP imaging findings related to COVID-19 vaccination (n = 66, 97%) were seen from first day to 4 weeks after vaccination. However, LAP remained after 5 and 6 weeks of the first and second dosages of COVID-19 vaccination with decreased lymph nodes' size and residual cortical thickening in two cases.

Conclusion: This review study of cases with LAP-associated COVID-19 vaccination guides radiologists and physicians to rely on patient's clinical context and updated resources to prevent potential disease upstaging and change in therapy.

Keywords: Adenopathy; Coronavirus; Moderna; Oxford-AstraZeneca; Pfizer-BioNTech; Radiology; SARS-CoV-2; Vaccination.

Publication types

  • Review

MeSH terms

  • COVID-19 Vaccines / adverse effects*
  • COVID-19* / prevention & control
  • Female
  • Humans
  • Lymphadenopathy* / chemically induced
  • Lymphadenopathy* / diagnostic imaging
  • Male
  • Vaccination / adverse effects*

Substances

  • COVID-19 Vaccines