key: cord-0701316-ve483azo
authors: Kebayoon, Amnuay; Wiwanitkit, Viroj
title: Dengue After COVID-19 Vaccination: Possible and Might be Missed
date: 2021-09-30
journal: Clin Appl Thromb Hemost
DOI: 10.1177/10760296211047229
sha: eeb49e19bceeeb10199040d705ec057ace5941da
doc_id: 701316
cord_uid: ve483azo

nan

Date received: 7 July 2021; accepted: 31 August 2021.

Dear Editor, COVID-19 vaccination is recommended as a primary prevention of COVID-19. Data on safety and adverse effect of the new COVID-19 vaccine is very important. Of several adverse effects, thromobytopenia might occur in some vaccine recipients and immunopathological mechanism is proposed. 1 A vaccine recipient who has vaccine -induced thrombocytopenia might have petechiae and hemorrhagic problem. Nevertheless, there might be other medical problem that leads to thrombocytopenia in a COVID-19 vaccine recipient.

A 38 years old female presented to the physician 2 days after receiving a viral vector COVID-19 vaccine. She developed myalgia, fever and skin rash and visited to a medical center. Her vital signs were as the followings: body temperature 38.5°C, blood pressure 120/80 mm Hg, pulse rate 85/min and respiratory rate 16/min. The diagnostic workup showed decreased platelet count (80 × 10 3 /µL). This case was firstly suspicious for a possible vaccine adverse reaction. Nevertheless, there is no coagulation profile abnormality. Since the setting is a tropical country that viral hemorrhagic disease is common, further investigation for viral hemorrhagic disease was performed. Further laboratory tests confirm that there is a positive result of dengue virus infection (Dengue NS1Ag + ve). The final diagnosis in this case is dengue. The patient receipt standard fluid replacement therapy. All of her clinical problems, including skin rash, disappeared within 1 week. This is a case of dengue hemorrhagic fever that occurs in a patient who has just received COVID-19 vaccination for 2 days. It is a possible condition that might occur in any tropical country during the current worldwide mass vaccination. It is necessary to recognize an endemic hemorrhagic fever that might cause thrombocytopenia in a COVID-19 vaccine recipient. This clinical problem might be missed diagnosed as an adverse event of vaccine. A coincidence of fever following COVID-19 vaccine and endemic tropical disease is a possible emerging problem in the present day. The present case is a good example and practitioner should aware of this scenario when dealing with post-vaccination thrombocytopenia problem.

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The author(s) received no financial support for the research, authorship and/or publication of this article.

Amnuay Kebayoon https://orcid.org/0000-0002-1976-2393

Thrombocytopenia including immune thrombocytopenia after receipt of mRNA COVID-19 vaccines reported to the vaccine adverse event reporting system (VAERS)

Coincidence of fever following COVID-19 vaccine and endemic tropical diseases: a challenge to clinicians during the global rollout of COVID-19 vaccination