Archives of Head and Neck Surgery
Archives of Head and Neck Surgery
Invited Narrative Review Miscellaneous

COVID-19 and cervical lymphadenopathy

Ana Cecilia C. Almeida de Moura, Fátima C. Mendes de Matos

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COVID-19 has brought a number of diseases secondary to viral infection, and there have been several reports on clinical manifestations related to vaccination. One of the effects reported in the literature, either related to the disease or to the vaccines, is the occurrence of cervical lymphadenopathy, which can result in a misleading differential diagnosis of malignant neoplasms. It is important that the specialist be aware of this differential diagnosis for an accurate management of cases.


COVID-19; COVID-19 vaccination; lymphadenopathy.


1. Distinguin L, Ammar A, Lechien JR, Chetrit A, Idrissi YC, Circiu M, Saussez S, Berradja N, Edjlali M, Carlier R, Hans S. MRI of patients infected with COVID-19 revealed cervical lymphadenopathy. Ear Nose Throat J. 2021;100(1):26-8. http:// PMid:32703030.

2. Capaccio P, Pignataro L, Corbellino M, Popescu-Dutruit S, Torretta S. Acute parotiditis: a possible precocious clinical manifestation of SARS-CoV2 infection? Otolaryngol Head Neck Surg. 2020;163(1):182-3. http://dx.doi. org/10.1177/0194599820926992. PMid:32369434.

3. Lechien JR, Chetrit A, Chekkoury-Idrissi Y, Distinguin L, Circiu M, Saussez S, Berradja N, Edjlali M, Hans S, Carlier R. Parotiditis-like symptoms associated with COVID-19, France, March-April 2020. Emerg Infect Dis. 2020;26(9):2270-1. PMid:32491984.

4. World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19 [Internet]. Switzerland: WHO; 2020 [cited 2022 Apr 8]. Available from:

5. Dawood FS, Porucznik CA, Veguilla V, Stanford JB, Duque J, Rolfes MA, Dixon A, Thind P, Hacker E, Castro MJE, Jeddy Z, Daugherty M, Altunkaynak K, Hunt DR, Kattel U, Meece J, Stockwell MS. Incidence rates, household infection risk, and clinical characteristics of sARS-CoV-2 infection among children and adults in Utah and New York City, New York. JAMA Pediatr. 2022;176(1):59-67. http:// PMid:34623377.

6. WHO. COVID-19 disease in children and adolescents: scientific brief [Internet]. Switzerland: WHO; 2021 [cited 2022 Apr 8]. Available from: publications/i/item/WHO-2019-nCoV-Sci_Brief-Children_and_adolescents-2021.1

7. Stokes EK, Zambrano LD, Anderson KN, Marder EP, Raz KM, El Burai Felix S, Tie Y, Fullerton KE. Coronavirus disease 2019 case surveillance - United States, January 22-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(24):759-65. PMid:32555134.

8. Liguoro I, Pilotto C, Bonanni M, Ferrari ME, Pusiol A, Nocerino A, Vidal E, Cogo P. SARS-COV-2 infection in children and newborns: a systematic review. Eur J Pediatr. 2020;179(7):1029-46. PMid:32424745.

9. Viner RM, Ward JL, Hudson LD, Ashe M, Patel SV, Hargreaves D, Whittaker E. Systematic review of reviews of symptoms and signs of COVID-19 in children and adolescents. Arch Dis Child. 2020;17:archdischild-2020-320972. PMid:33334728.

10. Deville JG, Song E, Ouellette CP, Jaime G, Deville, MD. COVID-19: clinical manifestations and diagnosis in children. UpToDate; 2021 Oct 25.

11. Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, Barranco MA, Maxted AM, Rosenberg ES, Easton D, Udo T, Kumar J, Pulver W, Smith L, Hutton B, Blog D, Zucker H. Multisystem inflammatory syndrome in children in New York State. N Engl J Med. 2020;383(4):347-58. NEJMoa2021756. PMid:32598830.

12. Son MBF, Friedman K. COVID-19: multisystem inflammatory syndrome in children (MIS-C) clinical features, evaluation, and diagnosis. UptoDate; 2021 Apr 2.

13. Morris SB, Schwartz NG, Patel P, Abbo L, Beauchamps L, Balan S, Lee EH, PanethPollak R, Geevarughese A, Lash MK, Dorsinville MS, Ballen V, Eiras DP, NewtonCheh C, Smith E, Robinson S, Stogsdill P, Lim S, Fox SE, Richardson G, Hand J, Oliver NT, Kofman A, Bryant B, Ende Z, Datta D, Belay E, Godfred-Cato S. Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 infection - United Kingdom and United States, March-August 2020. MMWR Morb Mortal Wkly Rep. 2020;69(40):1450-6. mmwr.mm6940e1. PMid:33031361.

14. Yasuhara J, Kuno T, Takagi H, Sumitomo N. Clinical characteristics of COVID‐19 in children: a systematic review. Pediatr Pulmonol. 2020;55(10):2565-75. http:// PMid:32725955.

15. Rivera-Figueroa EI, Santos R, Simpson S, Garg P. Incomplete Kawasaki disease in a child with COVID-19. Indian Pediatr. 2020;57(7):680-1. s13312-020-1900-0. PMid:32393680.

16. Blondiaux E,  et  al. Cardiac MRI of children with Multisystem Inflammatory Syndrome (MIS-C) associated with COVID-19: case series. Radiology. 2020;9:202288. 17. Mahase E. Covid-19: cases of inflammatory syndrome in children surge after urgent alert. BMJ. 2020;369:m1990. PMid:32414749.

18. Swann OV, Holden KA, Turtle L, Pollock L, Fairfield CJ, Drake TM, Seth S, Egan C, Hardwick HE, Halpin S, Girvan M, Donohue C, Pritchard M, Patel LB, Ladhani S, Sigfrid L, Sinha IP, Olliaro PL, Nguyen-Van-Tam JS, Horby PW, Merson L, Carson G, Dunning J, Openshaw PJM, Baillie JK, Harrison EM, Docherty AB, Semple MG. Clinical characteristics of children and young people admitted to hospital with covid-19 in United Kingdom: prospective multicentre observational cohort study. BMJ. 2020;370:m3249. PMid:32960186.

19. Zhang Q-Y, Xu B-W, Du J-B. Similarities and differences between multiple inflammatory syndrome in children associated with COVID-19 and Kawasaki disease: clinical presentations, diagnosis, and treatment. World J Pediatr. 2021;17(4):335-40. PMid:34013488.

20. Alamer E, Alhazmi A, Qasir NA, Alamer R, Areeshi H, Gohal G, Qadri M, Hashem AM, Algaissi A. Side effects of COVID-19 Pfizer-BioNTech mRNA vaccine in children aged 12-18 years in Saudi Arabia. Vaccines. 2021;9(11):1297. http://dx.doi. org/10.3390/vaccines9111297. PMid:34835228.

21. Studdiford J, Lamb K, Horvath K, Altshuler M, Stonehouse A. Development of unilateral cervical and supraclavicular lymphadenopathy after human papilloma virus vaccination. Pharmacotherapy. 2008;28(9):1194-7. phco.28.9.1194. PMid:18752390.

22. Hartsock RJ. Postvaccinial lymphadenitis: hyperplasia of lymphoid tissue that simulates malignant lymphomas. Cancer. 1968;21(4):632-49. http://dx.doi. org/10.1002/1097-0142(196804)21:43.0.CO;2-O. PMid:5647241.

23. Irvine DJ, Aung A, Silva M. Controlling timing and location in vaccines. Adv Drug Deliv Rev. 2020;158:91-115. PMid:32598970.

24. Cellina M, Irmici G, Carrafiello G. Unilateral axillary lymphadenopathy after coronavirus disease (COVID-19) vaccination. AJR Am J Roentgenol. 2021;216(5):W27. PMid:33617289.

25. Tu W, Gierada DS, Joe BN. COVID-19 vaccination-related lymphadenopathy: what to be aware of. Radiol Imaging Cancer. 2021;3(3):e210038. http://dx.doi. org/10.1148/rycan.2021210038. PMid:33874733.

26. Lehman CD, D’Alessandro HA, Mendoza DP, Succi MD, Kambadakone A, Lamb LR. Unilateral lymphadenopathy after COVID19 vaccination: a practical management plan for radiologists across specialties. J Am Coll Radiol. 2021;18(6):843-52. http:// PMid:33713605.

27. Tan N, Tay K, Wong SBJ, Nga ME. COVID‐19 post‐vaccination lymphadenopathy: report of cytological findings from fine needle aspiration biopsy. Diagn Cytopathol. 2021;49(12):E467-70. PMid:34432391.

28. Hiller N, Goldberg SN, Cohen-Cymberknoh M, Vainstein V, Simanovsky N. Lymphadenopathy associated with the COVID-19 vaccine. Cureus. 2021;13(2):e13524. PMid:33786231.

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