Arterial and venous thrombotic stroke after ChAdOx1 nCoV-19 vaccine

Wills, Adrian; Swallow, Gillian; Kirkman, Matthew A.; Rajan, Krishna; Subramanian, Ganesh

doi:10.7861/clinmed.2021-0321

Cited by 6 publications

(7 citation statements)

References 5 publications

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“…thrombocytopenia, high D-dimer levels, low fibrinogen, and positive anti-PF4 IgG antibodies). 54,55 These similarities suggest a common pathological pathway related to a coagulopathy induced by the vaccine. Nevertheless, some patients exhibit different paraclinical findings.…”

Section: Arterial Ischemic Strokementioning

confidence: 94%

“…Imaging revealed bilateral anterior cerebral artery (ACA) and right middle cerebral artery (MCA) occlusion. 54 Left hemiparesis was also de clinical manifestation in a 79-year-old male, in whom brain magnetic resonance imaging (MRI) showed lacunar infarcts in anterior circulation territories. 53 Similarly, involvement of the proximal segment of MCA was observed in a 51-year-old female who developed right-sided hemiplegia, hemianopia, and global aphasia 7 days after a ChAdOx1-S vaccine.…”

Section: Arterial Ischemic Strokementioning

confidence: 99%

See 1 more Smart Citation

Serious neurological adverse events following immunization against SARS-CoV-2: a narrative review of the literature

Eslait-Olaciregui,

Llinás-Caballero,

Patiño-Manjarrés

et al. 2023

Therapeutic Advances in Drug Safety

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Amid the coronavirus disease 2019 (COVID-19) pandemic, massive immunization campaigns became the most promising public health measure. During clinical trials, certain neurological adverse effects following immunization (AEFIs) were observed; however, acceptable safety profiles lead to emergency authorization for the distribution and use of the vaccines. To contribute to pharmacovigilance and lessen the potential negative impact that vaccine hesitancy would have on immunization programs, we conducted a review of the scientific literature concerning the epidemiological data, clinical presentation, and potential mechanisms of these neurological AEFIs. There is some epidemiological evidence linking COVID-19 vaccines to cerebral venous sinus thrombosis, arterial ischemic stroke, convulsive disorder, Guillain–Barré syndrome, facial nerve palsy, and other neurological conditions. Cerebral venous sinus thrombosis has been associated with a thrombotic thrombocytopenia induced by the vaccine, similar to that induced by heparin, which suggests similar pathogenic mechanisms (likely involving antibodies against platelet factor 4, a chemokine released from activated platelets). Arterial ischemic stroke is another thrombotic condition observed among some COVID-19 vaccine recipients. Vaccine-induced convulsive disorder might be the result of structural abnormalities potentially caused by the vaccine or autoimmune mechanisms. Guillain–Barré syndrome and facial nerve palsy may also be linked to the immunization event, possibly due to immune mechanisms such as uncontrolled cytokine release, autoantibody production, or bystander effect. However, these events are mostly uncommon and the evidence for the association with the vaccine is not conclusive. Furthermore, the potential pathophysiological mechanisms remain largely unknown. Nevertheless, neurological AEFIs can be serious, life-threatening or even fatal. In sum, COVID-19 vaccines are generally safe and the risk of neurological AEFIs does not outweigh the benefits of immunization. However, early diagnosis and treatment of neurological AEFIs are of utmost importance, and both health professionals and the public should be aware of these conditions.

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Section: Arterial Ischemic Strokementioning

confidence: 94%

Section: Arterial Ischemic Strokementioning

confidence: 99%

Serious neurological adverse events following immunization against SARS-CoV-2: a narrative review of the literature

Eslait-Olaciregui,

Llinás-Caballero,

Patiño-Manjarrés

et al. 2023

Therapeutic Advances in Drug Safety

View full text Add to dashboard Cite

show abstract

“…Last but not least, there are arterial thromboembolic incidents following the COVID-19 vaccination. Such a study was provided by Wills et al [155]. The authors reported two stroke cases due to arterial and venous thromboses within four weeks following the administration of the AstraZeneca vaccine.…”

Section: Summary Of Reported Literature Cases Of Ultrarare Vitt Compl...mentioning

confidence: 99%

Blood Coagulation and Thrombotic Disorders following SARS-CoV-2 Infection and COVID-19 Vaccination

Sekulovski,

Mileva,

Vasilev

et al. 2023

Biomedicines

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Although abundant data confirm the efficacy and safety profile of the developed vaccines against COVID-19, there are still some concerns regarding vaccination in high-risk populations. This is especially valid for patients susceptible to thrombotic or bleeding events and hesitant people due to the fear of thrombotic incidents following vaccination. This narrative review focuses on various inherited and acquired thrombotic and coagulation disorders and the possible pathophysiologic mechanisms interacting with the coagulation system during immunization in view of the currently available safety data regarding COVID-19 vaccines. Inherited blood coagulation disorders and inherited thrombotic disorders in the light of COVID-19, as well as blood coagulation and thrombotic disorders and bleeding complications following COVID-19 vaccines, along with the possible pathogenesis hypotheses, therapeutic interventions, and imaging for diagnosing are discussed in detail. Lastly, the lack of causality between the bleeding and thrombotic events and COVID-19 vaccines is debated, but still emphasizes the importance of vaccination against COVID-19, outweighing the minimal risk of potential rare adverse events associated with coagulation.

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“…Editor -We would like to share ideas on the publication 'Arterial and venous thrombotic stroke after ChAdOx1 nCoV-19 vaccine'. 1 Wills et al concluded that 'These cases illustrate that physicians should be especially mindful of vaccine-induced thrombosis with thrombocytopenia (VITT) in the context of evolving evidence on treatment and in view of the potentially rapid and catastrophic neurological deterioration, leading to fatality despite best supportive care.' We concur that there might be adverse effects of the COVID-19 vaccine and that neurological complication might be a serious one.…”

Section: Overviewmentioning

confidence: 99%