Background Many scientists across the world got involved in the race to develop successful anti-SARS-CoV-2 vaccines to overcome COVID-19 pandemic. Among the different vaccines developed against SARS-CoV-2, Covishield was the first vaccine approved for emergency use in Nepal. We report two cases of Superficial Vein Thrombosis (SVT) for the first time in the literature after vaccination with the Chimpanzee Adenovirus-vectored Vaccine (ChAdOx1 nCoV-19 vaccine). Cases presentation Two cases, a 24-year-old young Chhetri male and a 62-year-old Chhetri female who have received Covishield (ChAdOx1 nCoV-19) vaccine, developed pain in left calf after 2 weeks and 10 weeks of vaccination, respectively. Both the case belongs to the Chhetri ethnic group of Nepal. The pain became severe on the fourth week of immunization in the first case while the pain was acute and severe on the 10th week of vaccination in the second case. The first presented to emergency room and second case was referred to the emergency room from Orthopedic Clinic. On evaluation the first patient had normal vitals with no history of fever and swelling yet displayed non-radiating mild to moderate intensity pain localized to left leg below the knee which became aggravated by movements. In the second case however pain was more intense with other characteristics as first case. Both cases had low wells score (< 4). On local examination tenderness was noted on squeezing but other systemic examination findings of the patient were within normal limits in both cases. Among the numerous vaccines used to fight the battle against COVID-19 disease, the ChAdOx1 nCoV-19 vaccine, Covishield, has been widely used in Nepal and India. Apart from other minor side effects, in few cases thromboses have been reported after vaccination of ChAdOx1 nCoV-19, Covishield, vaccine. Conclusion These cases reporting Superficial Vein Thrombosis may be an additional adverse effect to the list of adverse events associated with ChAdOx1 nCoV-19, Covishield, vaccine. However, the benefits of the vaccine in breaking the chain of COVID 19 spread are certainly greater than the risk of thromboses.

Introduction: The vaccine has a positive impact on reducing the severity of COIVD-19 disease-course and studies have projected 50-90% protection against severe disease. Our study aimed to find the difference in disease severity outcomes between RT-PCR positive vaccinated and unvaccinated individuals. Method: This cross-sectional study was carried out among 417 COVID-19 cases who were admitted from June 2021 to August 2021. Collected data were fed into Microsoft-excel and analyzed using SPSS software, version- 16.0. Frequency, percentage, mean and standard deviation were calculated for descriptive analysis. To find out the association of categorical variables, Chi-square test or Fisher’s Exact test was used where appropriate. P-value <0.05 was considered significant. Result: Out of 417 cases, 23(5.5%) were fully vaccinated i.e. 10(2.4%) with Covishield and 13(3.1%) with Vero Cell, 48(11.5%) partially vaccinated i.e. 19(4.6%) with Covishield, and 29 (6.9%) with Vero Cell and 346(83%) unvaccinated. 343(82.25%) admitted patients were discharged and 74(17.75%) died during our study period. The disposition of the patient was statistically significant (p<0.001) and found more mortality among unvaccinated cases. There was a statistical difference between the requirement of ICU admission (p=0.032) among vaccinated and unvaccinated cases. The Absolute Risk Reduction (ARR) of mortality and requirement of ICU after complete vaccination with respect to unvaccinated COVID-19 patients was 14.11%(5.14%-23.73%) and 20.50%(8.02%-32.97%) respectively at 95% CI. Conclusion: Vaccination reduces Mortality, the requirement of ICU, and oxygen requirement among COVID-19 cases with respect to unvaccinated COVID-19 cases.

No abstract