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Choi S, Kim SH, Hwang JH, Jang HW, Oh SH, Kim DY, Kim TG. Rapidly progressing generalized bullous fixed drug eruption after the first dose of COVID-19 messenger RNA vaccination. J Dermatol 2023; 50:1190-1193. [PMID: 37102209 DOI: 10.1111/1346-8138.16808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/01/2023] [Accepted: 04/05/2023] [Indexed: 04/28/2023]
Abstract
Generalized bullous fixed drug eruption (GBFDE) is a rare type of life-threatening severe cutaneous adverse reaction that is considered a medical emergency because of its potential lethality. Currently, only a few cases of bullous adverse reactions have been reported after coronavirus disease 2019 (COVID-19) vaccination. We describe a patient with distinct clinical, histopathological, and immunological findings that are consistent with severe GBFDE, after Pfizer messenger RNA COVID-19 vaccination. An 83-year-old man presented with a fever and well-demarcated multiple erythematous patches that occurred only 4 h after receiving the first dose of COVID-19 Pfizer vaccination. Over the next few days, the patches became generalized and turned into blisters covering approximately 30% of the body surface. The patient was started on intravenous methylprednisolone and oral cyclosporine. There were no additional blistering lesions after 10 days of treatment, prompting a gradual dose reduction. Our case suggests that a stepwise vaccination adhering to the standard dosing schedule should be warranted with close monitoring for possible significant side effects.
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Affiliation(s)
- Sooyeon Choi
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sung Hee Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Ji-Hye Hwang
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyun Woo Jang
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Sang Ho Oh
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Do-Young Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Tae-Gyun Kim
- Department of Dermatology and Cutaneous Biology Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
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2
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Kabir S, Feit EJ, Heilman ER. Generalized fixed drug eruption following Pfizer-BioNtech COVID-19 vaccination. Clin Case Rep 2022; 10:e6684. [PMID: 36514459 PMCID: PMC9731164 DOI: 10.1002/ccr3.6684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 12/13/2022] Open
Abstract
Fixed drug eruption is a cutaneous drug reaction which recurs at the same site when the individual is exposed to the causative drug, characterized by single or multiple round sharply demarcated erythematous-to-violaceous patches. Here, we report a patient with generalized non-bullous fixed drug eruption following mRNA-based Pfizer-BioNTech COVID-19 vaccine.
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Affiliation(s)
- Soodeh Kabir
- Department of DermatologyState University of New York (SUNY) Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Eric J. Feit
- Department of DermatologyState University of New York (SUNY) Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Edward R. Heilman
- Department of DermatologyState University of New York (SUNY) Downstate Health Sciences UniversityBrooklynNew YorkUSA
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3
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McClatchy J, Yap T, Nirenberg A, Scardamaglia L. Fixed drug eruptions – the common and novel culprits since 2000. J Dtsch Dermatol Ges 2022; 20:1289-1302. [DOI: 10.1111/ddg.14870] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/13/2022] [Indexed: 01/18/2023]
Affiliation(s)
- Jessica McClatchy
- Dermatology Department The Royal Melbourne Hospital Melbourne Australia
- Faculty of Medicine Dentistry and Health Sciences The University of Melbourne Melbourne Australia
| | - Tami Yap
- Dermatology Department The Royal Melbourne Hospital Melbourne Australia
- Faculty of Medicine Dentistry and Health Sciences The University of Melbourne Melbourne Australia
- Melbourne Dental School The University of Melbourne Melbourne Australia
| | - Alexander Nirenberg
- Dorevitch Pathology Melbourne Australia
- Australasian College of Cutaneous Oncology Melbourne Australia
| | - Laura Scardamaglia
- Dermatology Department The Royal Melbourne Hospital Melbourne Australia
- Faculty of Medicine Dentistry and Health Sciences The University of Melbourne Melbourne Australia
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4
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McClatchy J, Yap T, Nirenberg A, Scardamaglia L. Fixes Arzneimittelexanthem – häufige und neue Auslöser seit dem Jahr 2000. J Dtsch Dermatol Ges 2022; 20:1289-1303. [DOI: 10.1111/ddg.14870_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 07/13/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Jessica McClatchy
- Dermatology Department The Royal Melbourne Hospital Melbourne Australien
- Faculty of Medicine Dentistry and Health Sciences The University of Melbourne Melbourne Australien
| | - Tami Yap
- Dermatology Department The Royal Melbourne Hospital Melbourne Australien
- Faculty of Medicine Dentistry and Health Sciences The University of Melbourne Melbourne Australien
- Melbourne Dental School The University of Melbourne Melbourne Australien
| | - Alexander Nirenberg
- Dorevitch Pathology Melbourne Australien
- Australasian College of Cutaneous Oncology Melbourne Australien
| | - Laura Scardamaglia
- Dermatology Department The Royal Melbourne Hospital Melbourne Australien
- Faculty of Medicine Dentistry and Health Sciences The University of Melbourne Melbourne Australien
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5
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Seol JE, Ahn SW, Jang SH, Hong SM, Kim MY, Kim H. A case of recurrent fixed drug eruption following the administration of 2 different coronavirus disease 2019 vaccines verified using intradermal and patch tests. JAAD Case Rep 2022; 33:23-26. [PMID: 36062201 PMCID: PMC9420036 DOI: 10.1016/j.jdcr.2022.08.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 02/08/2023] Open
Affiliation(s)
- Jung Eun Seol
- Department of Dermatology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Sang Woo Ahn
- Department of Dermatology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Seung Hee Jang
- Department of Dermatology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Seong Min Hong
- Department of Dermatology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Mi Yeong Kim
- Department of Internal Medicine, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea
| | - Hyojin Kim
- Department of Dermatology, Busan Paik Hospital, College of Medicine, Inje University, Busan, Korea,Correspondence to: Hyojin Kim, MD, PhD, Department of Dermatology, Busan Paik Hospital, College of Medicine, Inje University. 75, Bokji-ro, Busanjin-gu, Busan, Korea 47392.
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6
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Lu J, Liu Y, Sun Y. Generalized and persistent skin pigmentation after COVID-19 vaccination. J Eur Acad Dermatol Venereol 2022; 36:e963-e964. [PMID: 35770461 PMCID: PMC9350018 DOI: 10.1111/jdv.18379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Jiliang Lu
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Veneorology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yongxia Liu
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Veneorology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Yonghu Sun
- Shandong Provincial Hospital for Skin Diseases & Shandong Provincial Institute of Dermatology and Veneorology, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
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7
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Rekabi M, Sadati E, Mirzaei J, Pourdowlat G, Velayati AA, Honarpisheh P. Fixed drug eruption after the Sinopharm COVID‐19 vaccine. JEADV CLINICAL PRACTICE 2022. [PMCID: PMC9349928 DOI: 10.1002/jvc2.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
After coronavirus disease 2019 (COVID‐19) became widespread around the world, several vaccines have been developed with variable efficacy and potency and based on different platforms to control the pandemic. One of these vaccines is Sinopharm (BBIBP‐CorV), which is an inactivated virus that was released by Sinopharm's Beijing institute in the summer of 2020. The most commonly reported side effects of the Sinopharm vaccine have included pain at the injection site, muscle pain, headache and fatigue. Dermatological reactions are also reported as less common and were mainly local injection site reactions. Fixed drug eruption (FDE) is a rare and unusual adverse effect and accounts for less than 1% of all severe acute respiratory syndrome coronavirus 2 vaccine‐related cutaneous manifestations. FDE has not been reported following the COVID‐19 inactivated vaccine. Here, we describe a rare case of FDE following the administration of the first shot of the Sinopharm vaccine.
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Affiliation(s)
- Mahsa Rekabi
- Allergy and Immunology Department, Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Elham Sadati
- Allergy and Immunology Department, Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Jamal Mirzaei
- Infectious Disease Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Guitti Pourdowlat
- Chronic Respiratory Diseases Research Center National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Ali Akbar Velayati
- Allergy and Immunology Department, Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Parisa Honarpisheh
- Allergy and Immunology Department, Pediatric Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD) Shahid Beheshti University of Medical Sciences Tehran Iran
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8
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Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2022; 36:1947-1968. [PMID: 35666609 PMCID: PMC9348179 DOI: 10.1111/jdv.18294] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/18/2022] [Indexed: 01/08/2023]
Abstract
Although vaccination is widely accepted as an effective method of preventing and controlling the COVID-19 pandemic, many people are concerned about possible cutaneous side effects which can delay or prevent them from being vaccinated. The objectives of this systematic review were to assess the global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination. PubMed and Scopus databases were searched for articles published from January 1, 2019, to December 31, 2021, and reference lists for each selected article were screened. Case reports, case series, observational studies, and randomized controlled trials that provided information on cutaneous adverse reactions following COVID-19 vaccines were included. A total of 300 studies were included in a systematic review of which 32 studies with 946,366 participants were included in the meta-analysis. The pooled prevalence of cutaneous manifestations following COVID-19 vaccination was 3.8% (95% CI, 2.7%-5.3%). COVID-19 vaccines based on the mRNA platform had a higher prevalence than other platforms at 6.9% (95% CI, 3.8%-12.3%). Various cutaneous manifestations have been reported from injection site reactions which were the most common (72.16%) to uncommon adverse reactions such as delayed inflammatory reactions to tissue filler (0.07%) and flares of pre-existing dermatoses (0.07%). Severe cutaneous reactions such as anaphylaxis have also been reported, but in rare cases (0.05%). In conclusion, cutaneous adverse reactions are common, especially in those receiving mRNA vaccines. Most reactions are mild and are not contraindications to subsequent vaccination except for anaphylaxis, which rarely occurs. COVID-19 vaccination may also be associated with flares of pre-existing dermatoses and delayed inflammatory reactions to tissue filler. Patients with a history of allergies, pre-existing skin conditions, or scheduled for filler injections should receive additional pre-counseling and monitoring. A better understanding of potential side effects may strengthen public confidence in those wary of new vaccine technologies.
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Affiliation(s)
- C Washrawirul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Triwatcharikorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - M Ullman
- Department of Research Affairs, Chulalongkorn University, Bangkok, Thailand
| | - P Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - P Rerknimitr
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
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9
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Azzazi Y, Abdelkader HA, Khedr H, El-Komy MHM. Extensive cutaneous leukocytoclastic vasculitis after Sinopharm vaccine: case report and review of the literature. J Cutan Pathol 2022; 49:736-742. [PMID: 35355299 DOI: 10.1111/cup.14235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 03/17/2022] [Accepted: 03/27/2022] [Indexed: 11/30/2022]
Abstract
Cutaneous leukocytoclastic vasculitis (LCV) has been reported as a rare form of cutaneous reaction to different SARS-Cov-2 vaccines. Herein, we present the first case of cutaneous LCV following BBIBP-CorV (Sinopharm) vaccine, that occurred in a female patient with no prior comorbidities. A literature review about similar cases following different COVID-19 vaccines is discussed. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yousra Azzazi
- Department of Dermatology, Faculty of Medicine, Cairo University
| | | | - Hadeer Khedr
- Department of Dermatology, Faculty of Medicine, Cairo University
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10
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Singh A, Bharadwaj SJ, George C A, Ganguly S. Development of Severe Pemphigus Vulgaris Following ChAdOx1 nCoV‐19 Vaccination and Review of Literature. J Cosmet Dermatol 2022; 21:2311-2314. [PMID: 35348281 PMCID: PMC9115051 DOI: 10.1111/jocd.14945] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/06/2022] [Accepted: 03/24/2022] [Indexed: 11/30/2022]
Abstract
Vaccines are indeed a boon for tackling the present COVID‐19 pandemic. In India, ChAdOx1 nCoV‐19 (Covishield) is the most commonly used vaccine in the government vaccination program for adults more than 18 years of age. It is a recombinant vaccine developed by Oxford‐Astra Zeneca and manufactured in India by Serum Institute of India (SSI). Here, we report a case of severe pemphigus vulgaris following the second dose of ChAdOx1 nCoV‐19 vaccination in an adult male. The patient developed septicemia during the course of hospital stay, and he was managed with systemic steroids, parenteral antibiotics, and intravenous immunoglobulins (IVIg) along with proper wound care. Patient started improving within 1 month of therapy. This case is being reported in view of the rarity of pemphigus vulgaris following ChAdOx1 nCoV‐19 vaccine.
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Affiliation(s)
- Ajeet Singh
- Department of Dermatology, Venereology and Leprosy All India Institute of Medical Sciences Raipur Chhattisgarh India
| | - Sujana J Bharadwaj
- Department of Dermatology, Venereology and Leprosy All India Institute of Medical Sciences Raipur Chhattisgarh India
| | - Anju George C
- Department of Dermatology, Venereology and Leprosy All India Institute of Medical Sciences Raipur Chhattisgarh India
| | - Satyaki Ganguly
- Department of Dermatology, Venereology and Leprosy All India Institute of Medical Sciences Raipur Chhattisgarh India
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11
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Seque CA, Enokihara M, Nascimento MM, Porro AM, Tomimori J. Rare cutaneous reactions after ChAdOx1 (Oxford-AstraZeneca) vaccine: 12 case series from Brazil. J Eur Acad Dermatol Venereol 2022; 36:e601-e603. [PMID: 35349766 PMCID: PMC9114916 DOI: 10.1111/jdv.18112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022]
Affiliation(s)
- C A Seque
- Federal University of Sao Paulo, Dermatology department.Programa de Pós graduação em Medicina Translacional, Brazil
| | - Mmss Enokihara
- Federal University of Sao Paulo, Pathology department, Brazil
| | - M M Nascimento
- Federal University of Sao Paulo, Dermatology department, Brazil
| | - A M Porro
- Federal University of Sao Paulo, Dermatology department, Brazil
| | - J Tomimori
- Federal University of Sao Paulo, Dermatology department, Brazil
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12
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Ben Salem C, Khelif A, Sahnoun D, Ghariani N, Sriha B, Denguezli M. Another case of generalized bullous fixed drug eruption following an adenoviral-vector based Covid-19 vaccine (ChAdOx1 nCov-19). J Eur Acad Dermatol Venereol 2022; 36:e516-e517. [PMID: 35274363 PMCID: PMC9114837 DOI: 10.1111/jdv.18059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/07/2022] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Chaker Ben Salem
- Pharmacovigilance Center of Sousse, University of Sousse, Tunisia
| | | | - Dhouha Sahnoun
- Pharmacovigilance Center of Sousse, University of Sousse, Tunisia
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13
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AZD-1222. REACTIONS WEEKLY 2022. [PMCID: PMC8933181 DOI: 10.1007/s40278-022-11685-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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