Acute liver failure after vaccination against of COVID-19; a case report and review literature

• Published in: Respiratory medicine case reports Vol. 35; p. 101568
• Main Authors: Sohrabi, Masoudreza, Sobhrakhshankhah, Elham, Ziaei, Hosein, AtaeeKachuee, Manizhe, zamani, Farhad
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-01-2022; Elsevier
• Subjects: Case Report; COVID-19; Embolism; Liver; Vaccination; Amino acid cleaving enzyme; UK Medicines and other Health products Regulatory Agency; Partial thrombin time; Coronavirus disease 2019; Liver; Vaccination; Trans membrane serine protease 2; Embolism; Heparin-induced thrombocytopenia; COVID-19; Platelet factor 4; Adverse events; Prothrombin time; Complete Blood count; Intensive-care unit; European Medicines Agency; Partial thrombin time, PTT; Amino acid cleaving enzyme, FURIN; Adverse events, AEs; Coronavirus disease 2019, COVID-19; UK Medicines and other Health products Regulatory Agency, MHRA; Complete Blood count, CBC; Trans membrane serine protease 2, TMPRSS2; European Medicines Agency, EMA; Heparin-induced thrombocytopenia, HIT; Prothrombin time, PT; Platelet factor 4, PF4; Intensive-care unit, ICU
• ISSN: 2213-0071; 2213-0071
• DOI: 10.1016/j.rmcr.2021.101568

Vaccination against COVID-19 remains as a main root of COVID-19 prevention. Few vaccines have been launched for this purpose recently with different side effects. Thrombotic events have been reported as a rare side effect after ChAdox1nCOV-19 vaccination that may cause death of recipient.
We report a case of hepatic artery occlusion after the first dose vaccination by ChAdOx1nCov-19. The patient was a health care worker, aged 34-year old. Past medical history was unremarkable and had not used heparin. Over the next couple of days after the vaccination, he reported headache, nausea, and dizziness as well as abdominal pain. His general status and the laboratories studies deteriorate quickly by increasing liver enzymes and severe coagulopathy. Clinically he had presented acute hepatic failure. He had been received blood products, prednisolone pulse along with broad antibiotics without benefit. He died on the sixth day.
Thrombotic events after vaccination is very rare but can develop in main arteries with lethal outcome. This event may mimic autoimmune thrombosis clinically.