Arm lymphedema after vascularized lymph node harvest following Covid-19 vaccination

Figures & data

Figure 1. Clinical presentation of red streak on the volar side of the forearm several days after second dose of Covid-19 vaccination.

Figure 2. Lymphedema of the right forearm and back of the hand at initial presentation (a) right hand, (b) left hand).

Figure 3. Follow- up after 8 months showed complete regression of the edema at the wrist and only a minor lymphedema of the back of the hand.

Figure 4. Follow-up 2 years after surgery and 1.5 years after initial diagnosis of lymphedema of the right arm (a) right hand, (b) left hand).

Table 1. Overview to the reported cases discussing the interaction between COVID-19 vaccines in general and lymphedema.

	Age	Sex	Prior Primary/ secondary	Surgery (LVA)	Type of vaccination	Complication	Onset of complication	Study
1	45	female	Secondary, after cancer surgery	None	mRNA-1273 Spikevax	Cellulitis	After 2nd dose	Okazaki et al.
2	52	female	Secondary, for 7 years as an adverse effect of docetaxel	None	mRNA-1273 Spikevax	cellulitis four times in five months	21 days after 1st dose, 2nd, 3th and 4th month after 2nd dose
3	49	female	Secondary, lower left limb, lymphedema for 8 years after cancer surgery	LVA (multiple times)	mRNA BNT162b2	Cellulitis	Same day of the 2nd dose
4	52	female	Secondary after cancer surgery, lower left limb	LVA (multiple times)	mRNA BNT162b2	Cellulitis	11 days after 1st dose
5	79	female	None	None	mRNA BNT16b2	Lymphedema lower legs	After 2nd dose, time interval unknown	Chung et al.
6	79	male	None	None	mRNA BNT162b2	Lymphedema
7	68	female	None	None	Astra Zeneca	Lymphedema
8	68	male	None	None	Sinopharm	Lymphedema lower limbs bilateral and cellulitis	5 days after second dose	Hosseinzadeh et al.
9	45	female	Unknown	None	Vaxzevria	lymphedema left upper limb	10 days after 1st dose	Aimo et al.