Table 2.
A complete list of AHA reports from January 2021 to January 2024 in order of publication. DM2: diabetes mellitus type 2; HCV: hepatitis C virus; BPH: benign prostate hypertrophy; RBC: red blood cells; TXA: tranexamic acid; CS: Corticosteroids; rFVIIa: recombinant FVII activated; Cyc: Cyclophosphamide; aPCC: activated prothrombin complex concentrate; rFVIII: recombinant FVIII; DDAVP: desmopressin; FVIII/vWF: plasma-derived FVIII with von Willebrand factor; NA: not available.
| Ref. | Author(s), Year | Patient(s) (Sex; Age) | Vaccine Type | Dose(s) n |
Days after Vaccination | Clinical Manifestations | Concomitant Diseases |
Acute Treatments | Outcomes |
|---|---|---|---|---|---|---|---|---|---|
| [26] | Radwi & Farsi, 2021 | 1 (M; 69yrs) | BNT162b2 (Pfizer-BioNTech) | 2 | 9 | Spontaneous bruises on arms and legs | Prostate adenocarcinoma, DM2, hypertension | CS | Resolved without sequelae |
| [27] | Cittone et al., 2021 | 1 (M; 85 yrs) 1 (F; 86yrs) 1 (F; 72yrs) |
mRNA-1273 (Moderna) mRNA-1273 (Moderna) mRNA-1273 (Moderna |
2 2 1 |
Immediately after 2nd dose 21 10 |
Multiple hematomas on the right thigh, joint bleeding (knees) Traumatic hemothorax Table Extensive spontaneous cutaneous bruising |
Peripheral artery disease, coronary bypass Aortic valve stenosis Arterial disease |
rFVIIa, aPCC, CS, RTX rFVIIa, aPCC, CS rFVIIa, TXA, CS, RTX |
Active arterial bleeding after gall rupture, death Resolved without sequelae NA |
| [28] | Farley et al., 2021 | 1 (M; 67yrs) | BNT162b2 (Pfizer-BioNTech) | 2 | 21 | Large hematoma posterior left leg | Asymptomatic pulmonary sarcoidosis, hypertension | aPCC, rFVIIa, CS, RTX | Resolved without sequelae |
| [29] | Lemoine et al., 2022 | 1 (M; 70yrs) | mRNA-1273 (Moderna) |
1 | 8 | Extensive right upper limb bruising | Rheumatic polymyalgia, previous HCV infection | aPCC, rFVIIa, CS, Cyc | Resolved without sequelae |
| [30] | Leone et al., 2022 | 1 (M; 86yrs) 1 (F; 73yrs) 1 (M; 67yrs) 1 (M; 77yrs) |
BNT162b2 (Pfizer-BioNTech) BNT162b2 (Pfizer-BioNTech) BNT162b2 (Pfizer-BioNTech) BNT162b2 (Pfizer-BioNTech) |
2 2 2 2 |
14 26 49 52 |
Disseminated hematomas, severe anemia Spontaneous tongue, jaw, and right knee hematomas Tongue hematoma Hematuria, severe anemia |
Rheumatic polymyalgia Rheumatoid arthritis, Sjogren syndrome None Bladder cancer relapse |
RBC, CS CS rFVIIa, CS, Cyc rFVIIa, CS, RTX |
Resolved without sequelae Resolved without sequelae Resolved without sequelae Sepsis, respiratory complication, death |
| [31] | Murali et al., 2022 | 1 (F; 95yrs) | BNT162b2 (Pfizer-BioNTech) | 2 | 21 | Spontaneous bruising on limbs | Dementia, hypertension, depression, congestive cardiac failure, previous breast cancer | RBC, rFVIII, CS, RTX | Resolved without sequelae |
| [32] | Soliman et al., 2022 | 1 (F; 39yrs) | BNT162b2 (Pfizer-BioNTech) | 1 | 10 | Hematuria | None | CS, RTX | Resolved without sequelae |
| [33] | Vuen et al., 2022 | 1 (M; 80yrs) | BNT162b2 (Pfizer-BioNTech) | 1 | 14 | Ecchymosis at limbs, severe anemia | DM2, hypertension, dyslipidemia, chronic kidney disease, glaucoma in both eyes, ischemic stroke | rFVIIa, TXA, CS | Resolved without sequelae |
| [34] | Al Hennawi et al., 2022 | 1 (M; 75yrs) | BNT162b2 (Pfizer-BioNTech) | 2 | 90 | Soft tissue ecchymoses, compartment syndrome, anemia | Hypertension, dyslipidemia, coronary artery disease | rFVIIA, DDAVP, CS, RTX | Resolved without sequelae |
| [35] | Fu et al., 2022 | 1 (M; 77yrs) | mRNA-1273 (Moderna) |
2 | 21 | Bilateral legs, feet, and ankles ecchymosis | NA | aPCC, rFVIIa, CS, Cyc | Bullous pemphigoid |
| [36] | Plüß et al., 2022 | 1 (M; 72yrs) | BNT162b2 (Pfizer-BioNTech) | Booster | 9 | Arms, left leg, and trunk bruises | BPH, carpal tunnel syndrome | rFVIIa, CS, Cyc, RTX | Pleomorphic dermal sarcoma |
| [37] | Rashid et al., 2022 | 1 (M; 75yrs) | BNT162b2 (Pfizer-BioNTech) | Booster | 6 | Both thighs and back bruises | DM2 | RBC, rFVIIa, CS, Cyc | Resolved without sequelae |
| [38] | Melmed et al., 2022 | 1 (F; 61yrs) | mRNA-1273 (Moderna) |
2 | 14 | Inner thigh bruising, anemia with dyspnea | Rheumatoid arthritis | RBC, FVIII/vWF | Gastrointestinal bleeding |
| [39] | Hosoi et al., 2022 | 1 (F; 45yrs) | mRNA-1273 (Moderna) 1st and 2nd doses Pfizer BioNTech |
Booster | 14 | Subcutaneous hemorrhage | None | CS | Resolved without sequelae |
| [40] | Duminuco et al., 2023 | 1 (M; 71yrs) | BNT162b2 (Pfizer-BioNTech) | 2 | 8 | Hemothorax and hemoperitoneum in the abdomen, extending from the pelvic area to the right thigh | None | RBC, rFVIIa, CS, Cyc | Resolved without sequelae |
| [41] | Happaerts & Vanassche, 2022 | 1 (M; 75yrs) | Vaxzevria ChAdOx1 (AstraZeneca) |
1 | 10 | Multiple hematomas, hemorrhagic bullous pemphigoid, gastrointestinal ulcer | Chronic kidney disease, hypertension, DM2, polyneuropathy, chronic foot ulcer | rFVIIa, Emicizumab, RTX, CS | Atrial fibrillation, acute kidney injury, and methicillin-sensitive Staphylococcus aureus sepsis, death |
| [43] | Franchini & Focosi, 2023 | 1 (M; 67yrs) | mRNA-1273 (Moderna) |
1 | 22 | Anemia | Rheumatoid arthritis, pulmonary sarcoidosis | rFVIIa, RTX | Liposarcoma, death |
| [44] | Emna et al., 2023 | 1 (M; 69yrs) | CoronaVac (SinoVac) |
2 | 30 | Left inner thigh ecchymosis | None | RBC, TXA, CS | Resolved without sequelae |