Severe but Self-Limiting Polyarthralgia with Functional Impairment Following ChAdOx1 nCov-19 Vaccination in an Elderly Recipient
A 79-year-old female patient with no pre-existing rheumatological conditions presented with severe functional impairment secondary to polyarthralgia, most likely an adverse reaction following her first dose of Oxford/AstraZeneca ChAdOx1 nCov-19 vaccination against SARS-CoV-2, the causative agent of...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Vaccines |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2076-393X/9/11/1220 |
| _version_ | 1797508292689264640 |
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| author | Joel Ern Zher Chan Anand Irimpen |
| author_facet | Joel Ern Zher Chan Anand Irimpen |
| author_sort | Joel Ern Zher Chan |
| collection | DOAJ |
| description | A 79-year-old female patient with no pre-existing rheumatological conditions presented with severe functional impairment secondary to polyarthralgia, most likely an adverse reaction following her first dose of Oxford/AstraZeneca ChAdOx1 nCov-19 vaccination against SARS-CoV-2, the causative agent of Coronavirus Disease 2019 (COVID-19). The presentation mimicked clinical features of polymyalgia rheumatica and was distinctive in its pattern and delayed onset. Its severity in an elderly patient was significant against trial findings of decreasing reactogenicity of ChAdOx1 nCov-19 vaccine with increasing age, and traumatic to the patient. Acute phase reactants were elevated, consistent with recent similar reports among mostly elderly, female patients. New onset rheumatological conditions and flares of pre-existing, well-controlled conditions had been well established in COVID-19 and, to a lesser extent, post-vaccination. Viral arthralgias as a distinct clinical entity in COVID-19 is only beginning to be recognized. It could be that this case report represents a similar entity which occurs following vaccination against SARS-CoV-2. Despite this, the benefits of vaccination continue to outweigh such risks, although this case report is important for providing understanding of clinical progression when such reactions occur, aiding in patient discussions and clinical decisions to weigh up further investigations or empirical treatment against reassurance and close monitoring. |
| first_indexed | 2024-03-10T05:00:03Z |
| format | Article |
| id | doaj.art-44e1a5c7e89d41f39c0d3c9ab3828e6e |
| institution | Directory Open Access Journal |
| issn | 2076-393X |
| language | English |
| last_indexed | 2024-03-10T05:00:03Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj.art-44e1a5c7e89d41f39c0d3c9ab3828e6e2023-11-23T01:51:11ZengMDPI AGVaccines2076-393X2021-10-01911122010.3390/vaccines9111220Severe but Self-Limiting Polyarthralgia with Functional Impairment Following ChAdOx1 nCov-19 Vaccination in an Elderly RecipientJoel Ern Zher Chan0Anand Irimpen1Investigator Clinic, Port Lincoln, SA 5606, AustraliaInvestigator Clinic, Port Lincoln, SA 5606, AustraliaA 79-year-old female patient with no pre-existing rheumatological conditions presented with severe functional impairment secondary to polyarthralgia, most likely an adverse reaction following her first dose of Oxford/AstraZeneca ChAdOx1 nCov-19 vaccination against SARS-CoV-2, the causative agent of Coronavirus Disease 2019 (COVID-19). The presentation mimicked clinical features of polymyalgia rheumatica and was distinctive in its pattern and delayed onset. Its severity in an elderly patient was significant against trial findings of decreasing reactogenicity of ChAdOx1 nCov-19 vaccine with increasing age, and traumatic to the patient. Acute phase reactants were elevated, consistent with recent similar reports among mostly elderly, female patients. New onset rheumatological conditions and flares of pre-existing, well-controlled conditions had been well established in COVID-19 and, to a lesser extent, post-vaccination. Viral arthralgias as a distinct clinical entity in COVID-19 is only beginning to be recognized. It could be that this case report represents a similar entity which occurs following vaccination against SARS-CoV-2. Despite this, the benefits of vaccination continue to outweigh such risks, although this case report is important for providing understanding of clinical progression when such reactions occur, aiding in patient discussions and clinical decisions to weigh up further investigations or empirical treatment against reassurance and close monitoring.https://www.mdpi.com/2076-393X/9/11/1220COVID-19SARS-CoV-2vaccineOxford/AstraZenecaChAdOx1 nCov-19elderly patient |
| spellingShingle | Joel Ern Zher Chan Anand Irimpen Severe but Self-Limiting Polyarthralgia with Functional Impairment Following ChAdOx1 nCov-19 Vaccination in an Elderly Recipient Vaccines COVID-19 SARS-CoV-2 vaccine Oxford/AstraZeneca ChAdOx1 nCov-19 elderly patient |
| title | Severe but Self-Limiting Polyarthralgia with Functional Impairment Following ChAdOx1 nCov-19 Vaccination in an Elderly Recipient |
| title_full | Severe but Self-Limiting Polyarthralgia with Functional Impairment Following ChAdOx1 nCov-19 Vaccination in an Elderly Recipient |
| title_fullStr | Severe but Self-Limiting Polyarthralgia with Functional Impairment Following ChAdOx1 nCov-19 Vaccination in an Elderly Recipient |
| title_full_unstemmed | Severe but Self-Limiting Polyarthralgia with Functional Impairment Following ChAdOx1 nCov-19 Vaccination in an Elderly Recipient |
| title_short | Severe but Self-Limiting Polyarthralgia with Functional Impairment Following ChAdOx1 nCov-19 Vaccination in an Elderly Recipient |
| title_sort | severe but self limiting polyarthralgia with functional impairment following chadox1 ncov 19 vaccination in an elderly recipient |
| topic | COVID-19 SARS-CoV-2 vaccine Oxford/AstraZeneca ChAdOx1 nCov-19 elderly patient |
| url | https://www.mdpi.com/2076-393X/9/11/1220 |
| work_keys_str_mv | AT joelernzherchan severebutselflimitingpolyarthralgiawithfunctionalimpairmentfollowingchadox1ncov19vaccinationinanelderlyrecipient AT anandirimpen severebutselflimitingpolyarthralgiawithfunctionalimpairmentfollowingchadox1ncov19vaccinationinanelderlyrecipient |