Sex: F
Vaccine: COVID19
Symptoms: Angiogram, Aortic occlusion, Blood creatine phosphokinase, Blood creatinine, Blood lactic acid
Clinical narrative: received 1 dose of the mRNA COVID-19 vaccination and COVID-19 testing was positive; received 1 dose of the mRNA COVID-19 vaccination and COVID-19 testing was positive; Acute aortic occlusion; This is a literature report for the following literature source(s).  The authors presented the patient with COVID-19 complicated by AAO, the risk factors and typical presentation, and describe various therapeutic approaches available to physicians who may encounter similar presentations.  A 65-year-old female with a history of hypertension and hyperlipidemia presented with right lower extremity (RLE) numbness and weakness for 1 day. She initially called emergency medical services for pain in her RLE that started acutely that morning; however, by the time of presentation she endorsed primarily numbness and an inability to move her RLE most notably at the foot. She denied any left lower extremity (LLE) symptoms. She also noted intermittent shortness of breath, although she was unable to provide an exact timeline and had received 1 dose of the mRNA COVID-19 vaccination. Vitals were notable for tachycardia to the 120s with tachypnea in the 30s saturating 85% on room air. On examination she was anxious appearing, uncomfortable; however, she was not noted to be in extremis. Both lower extremities were cool without palpable or dopplerable pulses. She had absent motor and sensory function in the RLE distal to the knee with a normal LLE motor and sensory examination. Labs were notable for a leukocytosis of 20.0/nl, lactate of 7.4 mmol/L, creatinine kinase of 208 unit/L, and acute kidney injury with creatinine of 2.28. COVID-19 testing was positive. CT angiography revealed near occlusive filling defect of the infrarenal abdominal aorta, occlusive filling defect in the right common iliac artery as well as several occlusive defects within the left popliteal region. Moderate and mild degrees of atherosclerotic calcification were seen in the abdominal aorta and lower extremities, respectively. A heparin infusion was initiated in the ED. Vascular surgery performed bilateral aortoiliac and lower extremity thrombectomies, and RLE 4-compartment fasciotomies. The patient had a prolonged hospital stay complicated by the development of heparin-induced thrombocytopenia, multidrug resistant bacteremia, and multisystem organ failure and was ultimately transitioned to comfort care before death.  No follow up attempts are possible. NO further information is expected.; Sender's Comments: Based on available information and temporal association the causal role of suspect product cannot be excluded for reported events Case will be reviewed on receipt of FU information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate ; Reported Cause(s) of Death: received 1 dose of the mRNA COVID-19 vaccination and COVID-19 testing was positive; received 1 dose of the mRNA COVID-19 vaccination and COVID-19 testing was positive; multidrug resistant bacteremia; multisystem organ failure; Acute aortic occlusion;