Vaccine‐induced immune thrombotic thrombocytopenia after vaccination against Covid‐19: A clinical dilemma for clinicians and patients

Afshar, Zeinab Mohseni; Babazadeh, Arefeh; Janbakhsh, Alireza; Afsharian, Mandana; Saleki, Kiarash; Barary, Mohammad; Ebrahimpour, Soheil

doi:10.1002/rmv.2273

Cited by 35 publications

(43 citation statements)

References 70 publications

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“…Therefore, still further studies are needed to figure out other underlying mechanisms of the PVT following vaccination and solve this paradox. A recent cohort study stated the incidence of PVT following COVID-19 was 392.3 per million people, which was significantly higher than in PVT following vaccination (AstraZeneca and Jansen vaccines were excluded from this study) (49,50).…”

Section: Discussionmentioning

confidence: 91%

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Portal Vein Thrombosis Might Develop by COVID-19 Infection or Vaccination: A Systematic Review of Case-Report Studies

Kheyrandish

Rastgar²,

Arab‐Zozani³

et al. 2021

Front. Med.

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Background and Objective: Infection by the novel coronavirus disease 2019 (COVID-19) has been associated with different types of thrombotic complications same as portal vein thrombosis (PVT). However, by emerging vaccines of COVID, the thrombosis did not seem to be concerning anymore. Until new findings showed that, the vaccine of COVID itself can cause PVT.Method: We performed an electronic search in PubMed, Scopus, and Web of Sciences to evaluate the possibility of occurring PVT due to infection and vaccination of COVID-19. The results were reported in a narrative method and categorized into tables.Result: Overall, 40 cases of PVT from 34 studies were reviewed in this article. The prevalence of PVT following COVID-19 was more remarkable in males. However, it was more common in females after vaccinations of COVID-19 in the reviewed cases. Regardless of etiology, 20 of PVT cases reviewed in this article had at least one comorbidity. The most common clinical presentation was abdominal pain (AP). After anticoagulant therapies, most of the patients improved or discharged.Conclusion: As long as the laboratory findings are not appropriate enough to predict PVT, the diagnosis of this complication with whatever underlying reason is challengeable, while rapid diagnosis and treatment of that are vital. Therefore, by providing available data in an organized way, we aimed to prepare the information of infected patients for better and easier future diagnosis of PVT in new cases.

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Section: Discussionmentioning

confidence: 91%

“…In aHIT, it is not necessary for heparin to be present and other reasons same as free DNA do job of heparin. The free DNA attaches to PF4, and then platelets to make thrombus ( 49 ). The positive anti-PF4 antibody in seven out of nine reviewed cases somehow confirmed these findings.…”

Section: Discussionmentioning

confidence: 99%

Portal Vein Thrombosis Might Develop by COVID-19 Infection or Vaccination: A Systematic Review of Case-Report Studies

Kheyrandish

Rastgar²,

Arab‐Zozani³

et al. 2021

Front. Med.

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“…Live attenuated vaccines (LAV) are the most immunogenic vaccines without any adjuvant due to their effectiveness to provoke the immune system or immunity to mimic the natural infection (Minor 2015 ). Live attenuated viruses contain viable viruses with low virulence properties, live attenuated viruses are weak enough not to cause any diseases in a typical immune system.…”

Section: Traditional Vaccine Platform Uses In Covid-19 Vaccine Developmentmentioning

confidence: 99%

“…They reproduce slowly in the body, hence providing a long-term immunity against the pathogen as it remains a continuous antigen source. Live attenuated vaccines reduce the need for booster doses with single immunization (Minor 2015 ). Protection through live attenuated vaccine can be lifelong because LAV elicits both innate and adaptive immune systems; additionally, the production is economically feasible (Vignuzzi et al 2008 ).…”

Section: Traditional Vaccine Platform Uses In Covid-19 Vaccine Developmentmentioning

confidence: 99%

“…Possible treatment methods are high doses of intravenous immunoglobulins (IVIG), non-heparin-based anticoagulants, corticosteroid administration, and plasma exchange. After clinical stabilization, oral anticoagulants such as apixaban, rivaroxaban can be given (Iba et al 2021;Mohseni Afshar et al 2021;Siegler et al 2021).…”

Section: Thrombosis With Thrombocytopenia Syndrome (Tts)mentioning

confidence: 99%

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COVID-19 phase 4 vaccine candidates, effectiveness on SARS-CoV-2 variants, neutralizing antibody, rare side effects, traditional and nano-based vaccine platforms: a review

Simnani

Singh

Kaur³

2021

3 Biotech

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The COVID-19 pandemic has endangered world health and the economy. As the number of cases is increasing, different companies have started developing potential vaccines using both traditional and nano-based platforms to overcome the pandemic. Several countries have approved a few vaccine candidates for emergency use authorization (EUA), showing significant effectiveness and inducing a robust immune response. Oxford-AstraZeneca, Pfizer-BioNTech’s BNT162, Moderna’s mRNA-1273, Sinovac’s CoronaVac, Johnson & Johnson, Sputnik-V, and Sinopharm’s vaccine candidates are leading the race. However, the SARS-CoV-2 is constantly mutating, making the vaccines less effective, possibly by escaping immune response for some variants. Besides, some EUA vaccines have been reported to induce rare side effects such as blood clots, cardiac injury, anaphylaxis, and some neurological effects. Although the COVID-19 vaccine candidates promise to overcome the pandemic, a more significant and clear understanding is needed. In this review, we brief about the clinical trial of some leading candidates, their effectiveness, and their neutralizing effect on SARS-CoV-2 variants. Further, we have discussed the rare side effects, different traditional and nano-based platforms to understand the scope of future development.

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Unmasking sarcoidosis following SARS‐CoV‐2 vaccination: A case report

Mohaghegh

Hatami

Refaghat

et al. 2022

Clinical Case Reports

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Sarcoidosis is an inflammatory and granulomatous disorder, developed due to dysregulation between immune response and certain environmental antigens. We hereby report an interesting case of sarcoidosis following COVID‐19 vaccination (COVIran Barekat), which presented with inflammation of previous tattoo sites as well as the development of erythema nodosum and systemic lymphadenopathy, suggested a possible link between the COVID vaccination and dysregulation of the inflammatory process and served as a reminder for clinicians to have enough vigilance before proposing a vaccine booster to these patients.

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Vaccine‐induced immune thrombotic thrombocytopenia after vaccination against Covid‐19: A clinical dilemma for clinicians and patients

Cited by 35 publications

References 70 publications

Portal Vein Thrombosis Might Develop by COVID-19 Infection or Vaccination: A Systematic Review of Case-Report Studies

Portal Vein Thrombosis Might Develop by COVID-19 Infection or Vaccination: A Systematic Review of Case-Report Studies

COVID-19 phase 4 vaccine candidates, effectiveness on SARS-CoV-2 variants, neutralizing antibody, rare side effects, traditional and nano-based vaccine platforms: a review

Unmasking sarcoidosis following SARS‐CoV‐2 vaccination: A case report

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