Sonographic Assessment of Axillary Lymph Nodes Post COVID-19 Vaccine

Background The development of axillary lymphadenopathy post COVID-19 vaccine became an area of concern. This needs to be addressed and investigated to provide updated data that could contribute to its management and imaging guidelines. Objectives This study aims to detect possible changes in lymph nodes (LNs) after COVID-19 vaccination, decrease the rate of over-investigation and medical costs, and identify possible predisposing factors that could trigger the development of lymphadenopathy. Methods This was a retrospective cohort study conducted in King Fahad University Hospital, a secondary hospital in Al Khobar, Kingdom of Saudi Arabia (KSA), on a total of 1,257 vaccinated patients who underwent axillary ultrasonography (US) from December 2020 till the second of October 2022. All required data were collected using an Excel sheet and analyzed using Statistical Product and Service Solutions (SPSS, version 21) (IBM SPSS Statistics for Windows, Armonk, NY). Results Out of the 1183 cases, 460 (38.9%) cases had abnormal LNs post COVID-19 vaccine based on US, while LNs were normal in 723 (61.1%) cases. The prevalence of axillary lymphadenopathy was significantly more common in females than males (39.1% of cases in female patients versus 22.2% of cases in male patients (P = 0.049)). In addition, lymphadenopathy was more prevalent among patients who received the COVID-19 vaccine less than four weeks ago, compared to others who received the vaccine four to eight weeks ago, 8-12 weeks ago, and more than 12 weeks ago (100% vs 73.3% vs 34.2% vs 72% (P = 0.001)). Conclusion In conclusion, a significant number of patients were found to have lymphadenopathy after receiving the COVID-19 vaccine. The only predisposing factors identified to be associated with the development of lymphadenopathy were gender (females more than males) and duration since receiving the vaccine (four weeks).