J Korean Med Sci.  2021 Aug;36(34):e245. 10.3346/jkms.2021.36.e245.

Polyarthralgia and Myalgia Syndrome after ChAdOx1 nCOV-19 Vaccination

• Hyun H
• Song JY
• Seong H
• Yoon JG
• Noh JY
• Cheong HJ
• Kim WJ

• KMID: 2519599
• DOI: http://doi.org/10.3346/jkms.2021.36.e245

Abstract

Since February 26, 2021, when vaccination against coronavirus disease 2019 (COVID-19) began in South Korea, patients who visited the Korea University Guro Hospital with suspected adverse events after COVID-19 vaccination were monitored actively with interest. We encountered five unusual cases of polyarthralgia and myalgia syndrome in patients who received the ChAdOx1 nCOV-19 (AstraZeneca) vaccine. The patients (median age 67 years) were not previously diagnosed with arthropathy and rheumatologic diseases. They developed fever, myalgia, joint pain, and swelling three to seven days after vaccination. The symptoms persisted for up to 47 days despite antipyretic treatment. Arthralgia occurred in multiple joints, including small and large joints. A whole-body Technetium-99m methylene diphosphonate bone scan revealed unusual uptakes in the affected joints. Non-steroidal anti-inflammatory drugs with or without prednisolone relieved the symptoms of all patients. Further monitoring is required to clarify the long-term prognosis of this syndrome.

Keyword

COVID-19; Vaccine; Safety; Adverse Event; Arthritis

Figure

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  Fig. 1 Whole-body bone scan findings of patients with polyarthralgia and myalgia syndrome in ChAdOx1 nCOV-19 recipients. Increased uptakes in both first MTP and left knee joints were seen in patient 1; increased uptakes in both shoulders, elbows, wrists, ankles, multiple fingers, first MTP, and left knee joints in patient 2; increased uptakes in both wrists, ankles, multiple fingers, first MTP, and right knee joints in patient 3; increased uptakes in the cervical spine, both wrists, hands, fingers, and left foot joints in patient 5.MTP = metatarsophalangeal.

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