Double high-dose immunoglobulin for ChAdOx1 nCov-19 vaccine-induced immune thrombotic thrombocytopenia

Huang, Ching-Tai; Hsu, Shao‐Yun; Wang, Chien-Ho; Tseng, Wei‐En Johnny; Yang, Chan-Shan; Ng, Chip-Jin; Warkentin, Theodore E.; Cheng, Ming‐Huei

doi:10.1016/j.thromres.2021.07.017

Cited by 5 publications

(3 citation statements)

References 11 publications

(45 reference statements)

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“…Brain CT revealed lacunar infarction in the right centrum semiovale. His platelet count normalized after treatment with high-dose IVIG (2 g/kg for two consecutive days) and he was discharged without further thrombotic or hemorrhagic events [ 71 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical Research into Central Nervous System Inflammatory Demyelinating Diseases Related to COVID-19 Vaccines

Cheng,

Ho,

Hsu

et al. 2024

Diseases

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Various vaccines have been developed in response to the SARS-CoV-2 pandemic, and the safety of vaccines has become an important issue. COVID-19 vaccine-related central nervous system inflammatory demyelinating diseases (CNS IDDs) have been reported recently. We present one case of AstraZeneca vaccine-related myelin oligodendrocyte glycoprotein (MOG) antibody-associated disease and a literature review of another 78 patients published from January 2020 to October 2022. Patients were divided into three vaccine types (viral vector, mRNA, and inactivated vaccines) for further analyses. Among 79 patients with COVID-19 vaccine-related CNS IDDs, 49 (62%) cases received viral vector vaccines, 20 (25.3%) received mRNA vaccines, and 10 (12.7%) received inactivated vaccines. Twenty-seven cases (34.2%) were confirmed with autoantibodies, including fifteen patients (19%) with anti-MOG, eleven (13.9%) with anti-aquaporin 4 (AQP4), and one (1.3%) with both antibodies. Significantly, more males developed CNS IDDs post viral vector vaccines compared to mRNA and inactivated vaccines. Patients receiving mRNA vaccines were older than those receiving other types. Furthermore, mRNA and inactivated vaccines correlated more with anti-AQP4 antibodies, while viral vector vaccines showed higher MOG positivity. This research suggests potential associations between COVID-19 vaccine-related CNS IDDs and gender, age, and autoantibodies, contingent on vaccine types. Protein sequence analysis implies similarities between the S protein and AQP4/MOG. Further studies may elucidate the mechanisms of CNS IDDs, aiding vaccine selection for specific types.

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Section: Discussionmentioning

confidence: 99%

Clinical Research into Central Nervous System Inflammatory Demyelinating Diseases Related to COVID-19 Vaccines

Cheng,

Ho,

Hsu

et al. 2024

Diseases

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“…To our knowledge, only four additional cases of VITT were reported in other Asian countries by the end of August 2021. Two cases of definite VITT were reported from South Korea 7,8 and Taiwan 9‐11 . Most affected individuals were in their 30s, and most presented with clinical thrombosis and bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…A woman in her 70s presented with headache and drowsiness Two cases of definite VITT were reported from South Korea 7,8 and Taiwan. [9][10][11] Most affected individuals were in their 30s, and most presented with clinical thrombosis and bleeding. Of the nine mentioned cases, four were fatal, yielding a 44% fatality rate.…”

Section: Casementioning

confidence: 99%

Vaccine‐induced immune thrombotic thrombocytopenia with ChAdOx1 nCoV‐19 is rare in Asia

Boonyawat

Angchaisuksiri

2022

Research and Practice in Thrombosis and Haemostasis

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Background Vaccination with ChAdOx1 n‐CoV‐19 is associated with a rare syndrome called vaccine‐induced immune thrombotic thrombocytopenia (VITT). VITT has been reported mainly in Western countries, whereas the report of VITT in Asians is sparse. Objectives To report a case series of VITT following ChAdOx1 n‐CoV‐19 in Thailand and to estimate the incidence of VITT among Asian countries. Methods We retrieved the number of VITT patients and the total inoculation doses from the database of the Thai Ministry of Public Health. We performed a literature search including published articles and gray literature to estimate the incidence of VITT. The incidences of VITT by countries and respective confidence intervals were calculated. Results By the end of August 2021, five VITT cases occurred after 15 million doses of ChAdOx1 n‐CoV‐19 in Thailand. The median age was 31 years, and 60% were women. The incidence of VITT is estimated at 1 in 3 million. In other Asian countries, only a few cases of VITT have been reported. The incidence of VITT is much lower than in those of Western countries, which is estimated at 1 in 100, 000. The fatality rate was 44% in this study. Conclusions Although the incidence of VITT in Asians is low, the mortality rate is substantially higher. We urge that public awareness of this syndrome be raised, as early recognition and appropriate treatment of this syndrome following ChAdOx1 n‐CoV‐19 are crucial to improve the outcome.

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Azd-1222

2022

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Double high-dose immunoglobulin for ChAdOx1 nCov-19 vaccine-induced immune thrombotic thrombocytopenia

Cited by 5 publications

References 11 publications

Clinical Research into Central Nervous System Inflammatory Demyelinating Diseases Related to COVID-19 Vaccines

Clinical Research into Central Nervous System Inflammatory Demyelinating Diseases Related to COVID-19 Vaccines

Vaccine‐induced immune thrombotic thrombocytopenia with ChAdOx1 nCoV‐19 is rare in Asia

Azd-1222

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