Vaccine-Induced Immune Thrombotic Thrombocytopenia with Disseminated Intravascular Coagulation and Death following the ChAdOx1 nCoV-19 Vaccine

Aladdin, Yasser; Algahtani, Hussein; Shirah, Bader

doi:10.1016/j.jstrokecerebrovasdis.2021.105938

Cited by 35 publications

(25 citation statements)

References 16 publications

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“…Thrombotic events in cerebral veins are another neurological complication of SARS‐CoV‐2 vaccinations. VST has been most frequently reported after vaccinations with the AZV 10 . In most cases, VST occurred already after the first shot.…”

Section: Resultsmentioning

confidence: 99%

“…In most cases, VST occurred already after the first shot. Patients in whom VST was attributed to immune‐mediated thrombocytopenia received IVIGs or steroids in addition to heparin 10 . Notably, sixty‐two patients with post‐SARS‐CoV‐2 vaccination VST died 10 .…”

Section: Resultsmentioning

confidence: 99%

“…Patients in whom VST was attributed to immune‐mediated thrombocytopenia received IVIGs or steroids in addition to heparin 10 . Notably, sixty‐two patients with post‐SARS‐CoV‐2 vaccination VST died 10 . In the study with the highest number of patients experiencing a VST after shots with the AZV ( n = 187), Pfizer ( n = 25), or Moderna ( n = 1) vaccine, concomitant thrombocytopenia was found only among those having received the AZV 11 .…”

Section: Resultsmentioning

confidence: 99%

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Neurological side effects of SARS‐CoV‐2 vaccinations

Finsterer

2021

Acta Neuro Scandinavica

120

117

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Though SARS-CoV-2 vaccinations are usually sold as well tolerated, they can cause mild-to-severe side effects in some patients. 1 Since the benefit for the global population outweighs these adverse reactions, and since political and pecuniary interests create the image of a "safe and indispensable" tool against the currently dominant global burden, there is only moderate reporting and discussion about them. 2There is also an anti-vaccine movement in the world nowadays that also contributes to the biased assessment of these adverse effects.Usually, single case reports, case series, or registration studies report these side effects but systematic, transnational, multicenter, postmarketing investigations on this matter are infrequently done. This shortage of published information about type, frequency, severity, and therapeutic management of vaccination-related side effects is in contradiction to the daily experience of healthcare workers and affected probands, and may contribute to the individual or organized resistance and reservations against the vaccination from parts of the populations, the only moderate effect of vaccination campaigns, and the tendency to introduce compulsory vaccination. 3 Neurological side effects to SARS-CoV-2 vaccinations are usually mild, of short duration, self-limiting, and ambulatorily manageable.However, in some cases, these side effects are severe and require hospitalization or even admission to an intensive care unit (ICU). 4 Only, rarely these side effects can be fatal. 5 Since the virus and the adverse reactions to vaccinations show a tropism for neuronal structures and tissues this narrative review about the neurological side effects was conducted to collect and discuss published data in order to discover type, frequency, treatment, and outcome of these side effects and to eventually discover if certain patients are prone to

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Neurological side effects of SARS‐CoV‐2 vaccinations

Finsterer

2021

Acta Neuro Scandinavica

120

117

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“…The PF4/polyanion pair act as autoantigen-inducing antibodies of the IgG class. On the other hand, PF4-polyanion-IgG complexes can also be detected in 3-5% of healthy subjects, with a risk of platelet aggregation via FcRIIa/CD32 receptors on their surface, which could be a common pathway for VITT, HIT, or DIC syndromes [4,5,7,8,16,57,58]. Similarly, spike proteins during COVID-19 infection have also been demonstrated to cause PF4 degranulation, platelet aggregation, and thrombosis [4,64,65].…”

Section: Pathophysiological Mechanism(s) Of Thrombosismentioning

confidence: 99%

Cerebral Venous Sinus Thrombosis following COVID-19 Vaccination: Analysis of 552 Worldwide Cases

et al. 2022

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To date, billions of vaccine doses have been administered to restrain the current COVID-19 pandemic worldwide. Rare side effects, including intravascular blood clots, were reported in the general population after vaccination. Among these, cerebral venous sinus thrombosis (CVST) has been considered the most serious one. To shed further light on such an event, we conducted a literature search for case descriptions of CVST in vaccinated people. Findings were analyzed with emphasis on demographic characteristics, type of vaccine, site of thrombosis, clinical and histopathological findings. From 258 potential articles published till September 2021, 41 studies were retrieved for a total of 552 patients. Of these, 492 patients (89.1%) had received AZD1222/Vaxzevria, 45 (8.2%) BNT162b2/CX-024414 Spikevax, 15 (2.7%) JNJ-78436735, and 2 (0.3%) Covishield vaccine. CVST occurred in 382 women and 170 men (mean aged 44 years), and the median timing from the shot was 9 days (range 2–45). Thrombi were predominantly seen in transverse (84%), sigmoid (66%), and/or superior sagittal (56%) sinuses. Brain injury (chiefly intracranial bleeding) occurred in 32% of cases. Of 426 patients with detailed clinical course, 63% were discharged in good clinical conditions, at times with variable neurological sequelae, whereas 37% deceased, largely due to brain injury. This narrative review confirmed CVST as a rare event after (adenoviral vector) COVID-19 vaccination, with a women/men rate ratio of 2.25. Though the pathogenesis of thrombosis is still under discussion, currently available histopathological findings likely indicate an underlying immune vasculitis.

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“…Most patients received heparin followed by oral anticoagulants. Seven patients received IVIGs and six patients steroids because of concomitant vaccine-induced immune thrombotic thrombocytopenia [ 27 ]. Complete recovery was reported in only 5 patients.…”

Section: Main Textmentioning

confidence: 99%

Post-SARS-CoV-2 vaccination venous sinus thrombosis: a literature review of 308 cases

Finsterer

Zarrouk‐Mahjoub

2021

Egypt J Neurol Psychiatry Neurosurg

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There is accumulating evidence that SARS-CoV-2 vaccinations can be complicated by venous sinus thrombosis (VST). This review aimed at summarising and discussing previous and recent advances regarding the diagnosis, pathogenesis, treatment, and outcome of post-SARS-CoV-2 vaccination VST. At least 308 patients with post-SARS-CoV-2 vaccination VST have been reported as per the end of July 2021. Ages among these 308 patients ranged between 22 and 81 years, 69 were male and 197 were female. Post-SARS-CoV-2 vaccination VST most commonly occurred with the ChAdOx1-S vaccine followed by the BNT126b2 vaccine. In the vast majority of cases, VST occurred after the first dose. Only in six patients did VST occur after the second dose. Latency between vaccination and onset of VST ranged between 0 and 24 days. Regarding treatment, most patients received heparin followed by oral anticoagulants. Seven patients received IVIGs and six patients received steroids because of concomitant vaccine-induced immune thrombotic thrombocytopenia. Complete recovery was reported in 5 patients. Partial recovery was reported in 9 patients. Eight patients were alive or discharged. Sixty-two patients died. The outcome was not specified in the remainder. In conclusion, SARS-CoV-2 vaccinations can be complicated by VST. There is female preponderance and the outcome is frequently poor.

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Vaccine-Induced Immune Thrombotic Thrombocytopenia with Disseminated Intravascular Coagulation and Death following the ChAdOx1 nCoV-19 Vaccine

Cited by 35 publications

References 16 publications

Neurological side effects of SARS‐CoV‐2 vaccinations

Neurological side effects of SARS‐CoV‐2 vaccinations

Cerebral Venous Sinus Thrombosis following COVID-19 Vaccination: Analysis of 552 Worldwide Cases

Post-SARS-CoV-2 vaccination venous sinus thrombosis: a literature review of 308 cases

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