Thrombotic thrombocytopenic purpura (TTP) after COVID-19 vaccination: A systematic review of reported cases

Saluja, Prachi; Gautam, Nitesh; Yadala, Sisira; Venkata, Anand N.

doi:10.1016/j.thromres.2022.04.020

Cited by 26 publications

(24 citation statements)

References 34 publications

(30 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, cases of iTTP secondary to vaccination against SARS-CoV-2 have been regularly uploaded to databases (Table 3). Seventeen of these cases have been described ( [77][78][79][80][81][82][83][84][85][86][87][88][89], reviewed in [90]). Thirteen of them corresponded to the first acute episode of iTTP [77,78,[80][81][82][83][84][85][86][87], and the remaining ones were relapses of preexisting iTTP [79,88,89].…”

Section: Covid-19 Covid-19 Vaccination and Ittpmentioning

confidence: 99%

COVID-19 Vaccines and Autoimmune Hematologic Disorders

et al. 2022

View full text Add to dashboard Cite

Worldwide vaccination against SARS-CoV-2 has allowed the detection of hematologic autoimmune complications. Adverse events (AEs) of this nature had been previously observed in association with other vaccines. The underlying mechanisms are not totally understood, although mimicry between viral and self-antigens plays a relevant role. It is important to remark that, although the incidence of these AEs is extremely low, their evolution may lead to life-threatening scenarios if treatment is not readily initiated. Hematologic autoimmune AEs have been associated with both mRNA and adenoviral vector-based SARS-CoV-2 vaccines. The main reported entities are secondary immune thrombocytopenia, immune thrombotic thrombocytopenic purpura, autoimmune hemolytic anemia, Evans syndrome, and a newly described disorder, so-called vaccine-induced immune thrombotic thrombocytopenia (VITT). The hallmark of VITT is the presence of anti-platelet factor 4 autoantibodies able to trigger platelet activation. Patients with VITT present with thrombocytopenia and may develop thrombosis in unusual locations such as cerebral beds. The management of hematologic autoimmune AEs does not differ significantly from that of these disorders in a non-vaccine context, thus addressing autoantibody production and bleeding/thromboembolic risk. This means that clinicians must be aware of their distinctive signs in order to diagnose them and initiate treatment as soon as possible.

show abstract

Section: Covid-19 Covid-19 Vaccination and Ittpmentioning

confidence: 99%

COVID-19 Vaccines and Autoimmune Hematologic Disorders

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Following COVID-19 infection and SARS-CoV-2 vaccination, an increased risk of thrombotic events like pulmonary embolism, myocardial infarction, and stroke are reported (41,(44)(45)(46). Cytokine storm and hypoxia resulting in endothelial damage, platelet activation as well as activation of the coagulation cascade are discussed as the underlying mechanisms leading to coagulation abnormalities (47-49).…”

Section: Impact Of a Dysbalanced Ras On Coagulation Cascadesmentioning

confidence: 99%

The rationale for the treatment of long-Covid symptoms – A cardiologist's view

Schieffer

2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

The ongoing coronavirus disease 2019 pandemic left us with thousands of patients suffering from neurological, cardiovascular, and psychiatric disorders named post-acute sequelae of COVID-19 or just long-Covid. In parallel, the vaccination campaigns against SARS-CoV-2 spike protein saved millions of lives worldwide but long-Covid symptoms also appeared rarely following vaccination with a strong overlap to the “canonical” long-Covid symptoms. A therapeutic strategy targeting both, post-VAC and post-SARS-CoV-2 long-Covid symptoms is warranted since exposure to the S-protein either by vaccination or SARS-CoV-2 infection may trigger identical immuno-inflammatory cascades resulting in long-Covid symptoms.

show abstract

“…In addition, schistocytes and TTP have even been observed after anti‐COVID‐19 vaccination. 63 , 97 , 98 , 99 , 100 , 101 …”

Section: Peripheral Blood Cell Morphology In Covid‐19mentioning

confidence: 99%

“… 4 , 7 , 12 , 59 , 60 Other literature reviews were dedicated specifically to eosinophils, 61 RBCs, 62 and the association of thrombotic thrombocytopenic purpura (TTP) with COVID‐19 or anti‐COVID‐19 vaccination. 63 …”

Section: Introductionmentioning

confidence: 99%

“…Besides several reviews limited to quantitative FBC data in COVID‐19, 10,57,58 five reviews on haematological features of the PB in COVID‐19 include variably extended cytomorphological information 4,7,12,59,60 . Other literature reviews were dedicated specifically to eosinophils, 61 RBCs, 62 and the association of thrombotic thrombocytopenic purpura (TTP) with COVID‐19 or anti‐COVID‐19 vaccination 63 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Coronavirus disease 2019 (COVID‐19): Focus on peripheral blood cell morphology

Zini

D’Onofrio

2022

Br J Haematol

View full text Add to dashboard Cite

Summary Numerous studies have shown peculiar morphological anomalies in COVID‐19 patients' smears. We searched all the peer‐reviewed scientific publications that explicitly reference the cytomorphological alterations on peripheral blood smears of patients with COVID‐19. We extracted data from sixty‐five publications (case reports, patient group studies, reviews, and erythrocyte morphology studies). The results show that frequent alterations concern the morphology of lymphocytes (large lymphocytes with weakly basophilic cytoplasm, plasmacytoid lymphocytes, large granular lymphocytes). Neutrophils display abnormal nuclei and cytoplasm in a distinctive cytomorphological picture. Besides a left shift in maturation, granulations can be increased (toxic type) or decreased with areas of basophilia. Nuclei are often hyposegmented (pseudo‐Pelger‐Huёt anomaly). Apoptotic or pycnotic cells are not uncommon. Monocytes typically have a large cytoplasm loaded with heterogeneous and coalescing vacuoles. Platelets show large and giant shapes. The presence of erythrocyte fragments and schistocytes is especially evident in the forms of COVID‐19 that are associated with thrombotic microangiopathies. Such atypia of blood cells reflects the generalized activation in severe COVID‐19, which has been demonstrated with immunophenotypic, molecular, genetic, and functional methods. Neutrophils, in particular, are involved in the pathophysiology of hyperinflammation with cytokine storm, which characterizes the most unfavorable evolution.

show abstract

Thrombotic thrombocytopenic purpura (TTP) after COVID-19 vaccination: A systematic review of reported cases

Cited by 26 publications

References 34 publications

COVID-19 Vaccines and Autoimmune Hematologic Disorders

COVID-19 Vaccines and Autoimmune Hematologic Disorders

The rationale for the treatment of long-Covid symptoms – A cardiologist's view

Coronavirus disease 2019 (COVID‐19): Focus on peripheral blood cell morphology

Contact Info

Product

Resources

About