5 research outputs found
Axillary lymph node imaging in mRNA, vector-based, and mix-and-match COVID-19 vaccine recipients: ultrasound features
Objectives To assess ultrasound characteristics of ipsilateral axillary lymph nodes after two doses of four different COVID-19
vaccination protocols, to determine whether these parameters differed with age, and to describe how they changed on follow-up
imaging.
Methods A total of 247 volunteer employees from our center who had received two doses of COVID-19 vaccination were
recruited and followed prospectively. Axillary ultrasound of the ipsilateral vaccinated arm was performed the week after
receiving the second dose to analyze lymph node features (number, long-axis, cortical thickness, morphology, and vascular
imaging). Axillary lymphadenopathy resulting from four vaccination protocols—mRNA (BNT162b2, mRNA-1273),
ChAdOx1-S, and mix-and-match—was compared. Analysis was conducted using the Kruskal-Wallis test and post hoc analysis
with Bonferroni corrections. Nodal reactogenicity was evaluated for two age groups: young (< 45 years old) and middle-aged ( ≥
45 years old). All parameters were compared between both groups using an unpaired-sample Student t test. A p value < 0.05 was
considered statistically significant.
Results Significantly higher values for total number of visible nodes, cortical thickness, Bedi’s classification (p < 0.001), and
vascularity (p < 0.05) were observed in mRNA vaccine recipients compared to full ChAdOx1-S protocol recipients. Moreover,
mix-and-match protocol recipients showed greater nodal cortical thickness and higher Bedi’s classification than full ChAdOx1-S
recipients (p < 0.001). Analyses between age groups revealed greater cortical thickness, Bedi’s classification, and color Doppler
signal in younger patients (p < 0.05).
Conclusions Nodal parameters of Bedi’s classification and cortical thickness were more often increased in mRNA and mix-andmatch vaccine recipients when compared to ChAdOx1-S vaccine alone, especially in younger patients.
Key Points
• Hyperplastic lymphadenopathy was observed more frequently in mRNA and mix-and-match vaccine protocols compared to full
vector-based vaccination.
• Higher values for cortical thickness, Bedi’s classification, and color Doppler signal parameters were identified in younger
patients.
• Observed lymph node findings normalized in greater than 80% of patients by the third month following vaccination
Unilateral axillary adenopathy induced by COVID-19 vaccine: US follow-up evaluation
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-naĂŻve patients
Unilateral axillary adenopathy induced by COVID-19 vaccine: US follow-up evaluation
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-naĂŻve patients
Axillary lymph node imaging in mRNA, vector-based, and mix-and-match COVID-19 vaccine recipients: ultrasound features
Objectives To assess ultrasound characteristics of ipsilateral axillary lymph nodes after two doses of four different COVID-19
vaccination protocols, to determine whether these parameters differed with age, and to describe how they changed on follow-up
imaging.
Methods A total of 247 volunteer employees from our center who had received two doses of COVID-19 vaccination were
recruited and followed prospectively. Axillary ultrasound of the ipsilateral vaccinated arm was performed the week after
receiving the second dose to analyze lymph node features (number, long-axis, cortical thickness, morphology, and vascular
imaging). Axillary lymphadenopathy resulting from four vaccination protocols—mRNA (BNT162b2, mRNA-1273),
ChAdOx1-S, and mix-and-match—was compared. Analysis was conducted using the Kruskal-Wallis test and post hoc analysis
with Bonferroni corrections. Nodal reactogenicity was evaluated for two age groups: young (< 45 years old) and middle-aged ( ≥
45 years old). All parameters were compared between both groups using an unpaired-sample Student t test. A p value < 0.05 was
considered statistically significant.
Results Significantly higher values for total number of visible nodes, cortical thickness, Bedi’s classification (p < 0.001), and
vascularity (p < 0.05) were observed in mRNA vaccine recipients compared to full ChAdOx1-S protocol recipients. Moreover,
mix-and-match protocol recipients showed greater nodal cortical thickness and higher Bedi’s classification than full ChAdOx1-S
recipients (p < 0.001). Analyses between age groups revealed greater cortical thickness, Bedi’s classification, and color Doppler
signal in younger patients (p < 0.05).
Conclusions Nodal parameters of Bedi’s classification and cortical thickness were more often increased in mRNA and mix-andmatch vaccine recipients when compared to ChAdOx1-S vaccine alone, especially in younger patients.
Key Points
• Hyperplastic lymphadenopathy was observed more frequently in mRNA and mix-and-match vaccine protocols compared to full
vector-based vaccination.
• Higher values for cortical thickness, Bedi’s classification, and color Doppler signal parameters were identified in younger
patients.
• Observed lymph node findings normalized in greater than 80% of patients by the third month following vaccination
Prediction of effective humoral response to SARS‑CoV‑2 vaccines in healthy subjects by cortical thickness of post‑vaccination reactive lymphadenopathy
Purpose To study the association between ultrasound cortical thickness in reactive post-vaccination lymph nodes and the
elicited humoral response and to evaluate the performance of cortical thickness as a predictor of vaccine effectiveness in
patients with and without a previous history of COVID-19 infection.
Methods A total of 156 healthy volunteers were recruited and followed prospectively after receiving two COVID-19 vaccination
doses using different protocols. Within a week after receiving the second dose, an axillary ultrasound of the ipsilateral
vaccinated arm was performed, and serial post-vaccination serologic tests (PVST) were collected. Maximum cortical
thickness was chosen as a nodal feature to analyze association with humoral immunity. Total antibodies quantified during
consecutive PVST in previously-infected patients and in coronavirus-naïve volunteers were compared (Mann–Whitney U
test). The association between hyperplastic-reactive lymph nodes and effective humoral response was studied (odds ratio).
The performance of cortical thickness in detecting vaccination effectiveness was evaluated (area under the ROC curve).
Results Significantly higher values for total antibodies were observed in volunteers with a previous history of COVID-19
infection (p < 0.001). The odds ratio associating immunized coronavirus-naĂŻve volunteers after 90 and 180 days of the second
dose with a cortical thickness ≥ 3 mm was statistically significant (95% CI 1.52–6.97 and 95% CI 1.47–7.29, respectively).
The best AUC result was obtained comparing antibody secretion of coronavirus-naĂŻve volunteers at 180 days (0.738).
Conclusions Ultrasound cortical thickness of reactive lymph nodes in coronavirus-naĂŻve patients may reflect antibody production
and a long-term effective humoral response elicited by vaccination.
Clinical relevance statement In coronavirus-naĂŻve patients, ultrasound cortical thickness of post-vaccination reactive lymphadenopathy
shows a positive association with protective antibody titers against SARS-CoV-2, especially in the long term,
providing new insights into previous publications