SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia

Liu, Yumei; Shao, Zonghong; Wang, Huaquan

doi:10.1016/j.thromres.2021.12.002

Cited by 7 publications

(5 citation statements)

References 40 publications

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“…Cases of immune thrombocytopenia and bleeding without thrombosis were also reported in subjects immunized with BNT162b2. VITT is characterized by a very low prevalence but is associated with rapid progression and a high mortality rate, requiring constant surveillance [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Adverse Events Associated with BNT162b2 and AZD1222 Vaccines in the Real World: Surveillance Report in a Single Italian Vaccine Center

Costantino

Sellitto

Conti

et al. 2022

JCM

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Aim: Despite huge efforts in developing specific drugs, vaccination represents the only effective strategy against COVID-19. Efficacy and safety of the COVID-19 vaccines were established during clinical trials. Nonetheless, it is very important to perform continuous surveillance. This observational study aimed to report potential Adverse Events Following Immunization (AEFI) following the first dose of two different COVID-19 vaccines, BNT162b2 and AZD1222. Methods and Results: Subjects who underwent vaccination at the vaccine center of the University Hospital of Salerno, Italy, were interviewed using an ad hoc questionnaire. AZD-vac group (n = 175) who received AZD1222 had a higher number of AEFI than the BNT-vac group (n = 1613) who received BNT162b2 (83% vs. 42%). The most frequent AEFI associated with AZD1222 and BNT162b2 were fever and pain at the injection site, respectively. The AZD-vac group used drugs to contrast AEFI more frequently than the BNT-vac group. In the BNT-vac group, there was a higher incidence of AEFI in women than in men (26.2% vs. 15.8%, p = 0.01), while no gender-related difference was observed in the AZD-vac group. Conclusions: AZD1222 and BNT162b2 vaccines show a good safety profile. Based on our results and literature data, there are no reasons to justify the reluctance that persists towards immunization.

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Section: Introductionmentioning

confidence: 99%

Adverse Events Associated with BNT162b2 and AZD1222 Vaccines in the Real World: Surveillance Report in a Single Italian Vaccine Center

Costantino

Sellitto

Conti

et al. 2022

JCM

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show abstract

“…Parallels among VITT, HIT, and APS have often been described, as all three are antibody-mediated processes associated with thromboembolic manifestations. Patients with VITT or HIT may be positive for aPL, although the clinical significance of aPL in these conditions is uncertain [ [110] , [111] , [112] , [113] ]. One study of 126 aPL-positive patients (89 with APS, 37 with asymptomatic aPL) who mostly received the Pfizer-BioNTech COVID-19 vaccine found anti-PF4 antibodies in 9 patients, with no significant change in anti-PF4 antibody titres before or after vaccination in either APS or asymptomatic aPL-positive patients [ 114 ].…”

Section: Covid-19 Vaccination In Apsmentioning

confidence: 99%

COVID-19 and antiphospholipid antibodies

Butt

Erkan²,

Lee³

2022

Best Practice & Research Clinical Haematology

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“…Faced with any post-vaccination thrombocytopenia, it will be necessary to be vigilant in case the condition is the beginning of a VITT. The incidence of VITT is 3.8 cases per million vaccinated with SARs-COV-2 adenovirus vaccines [ 34 , 36 ]. VITT is an autoimmune disease, characterized by antibodies that directly activate platelets, triggering thrombosis in the arterial and venous circulation.…”

Section: Thrombocytopenia Secondary To Vaccination For Sars-cov-2mentioning

confidence: 99%

Recommendations on the Management of Patients with Immune Thrombocytopenia (ITP) in the Context of SARS-CoV-2 Infection and Vaccination: Consensus Guidelines from a Spanish ITP Expert Group

et al. 2022

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Primary immune thrombocytopenia (ITP) is an acquired autoimmune disease with highly variable presentation, characteristics, and clinical course. Thrombocytopenia is a common complication of many viral infections, including SARS-CoV-2. In addition, both de novo ITP and exacerbation of ITP after vaccination against SARS-CoV-2 have been reported. Patients infected with SARS-CoV-2 develop a prothrombotic coagulopathy called COVID-19-associated coagulopathy (CAC). In addition, autoimmune hematological disorders secondary to SARS-CoV-2 infection, mainly ITP and autoimmune hemolytic anemia (AIHA), have been described. Furthermore, SARS-CoV-2 infection has been associated with exacerbation of autoimmune processes, including ITP. In fact, there is evidence of a high relapse rate in patients with preexisting ITP and COVID-19. As for vaccination against SARS-CoV-2, hematological adverse events (HAE) are practically anecdotal. The most common HAE is thrombocytopenia-associated thrombosis syndrome (TTS) linked to vectored virus vaccines. Other HAEs are very rare, but should be considered in patients with previous complement activation disease or autoimmunity. In patients with ITP who are vaccinated against SARS-CoV-2, the main complication is exacerbation of ITP and the bleeding that may result. In fact, this complication occurs in 12% of patients, with splenectomized and refractory patients with more than five lines of previous treatment and platelet counts below 50 × 10 9 /L being the most vulnerable. We conclude that, in general, there is no greater risk of severe SARS-CoV-2 infection in ITP patients than in the general population. Furthermore, no changes are advised in patients with stable ITP, the use of immunosuppressants is discouraged unless there is no other therapeutic option, and patients with ITP are not contraindicated for vaccination against COVID-19.

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SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia

Cited by 7 publications

References 40 publications

Adverse Events Associated with BNT162b2 and AZD1222 Vaccines in the Real World: Surveillance Report in a Single Italian Vaccine Center

Adverse Events Associated with BNT162b2 and AZD1222 Vaccines in the Real World: Surveillance Report in a Single Italian Vaccine Center

COVID-19 and antiphospholipid antibodies

Recommendations on the Management of Patients with Immune Thrombocytopenia (ITP) in the Context of SARS-CoV-2 Infection and Vaccination: Consensus Guidelines from a Spanish ITP Expert Group

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