Development and exacerbation of autoimmune hemolytic anemia following <scp>COVID</scp>‐19 vaccination: A systematic review

Jafarzadeh, Abdollah; Jafarzadeh, Sara; Pardehshenas, Mohammad; Nemati, Maryam; Mortazavi, Seyed Mohammad Javad

doi:10.1111/ijlh.13978

Cited by 15 publications

(12 citation statements)

References 37 publications

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“…6,7,9,10,12,15–17,19–21 Coagulation defects risk increased with both mRNA vaccine and viral vector vaccine, with no difference in risk between the two vaccines. While hemolytic anemia has been reported following COVID-19 vaccination, 17,23,26 especially with mRNA vaccines, 17,23,26 our study found that the incidence of hemolytic anemia was low in the COVID-19 vaccine recipient group, regardless of the vaccine type. This suggests the need for further research to confirm the mechanisms between COVID-19 vaccine components and RBC antibodies in a larger population.…”

Section: Discussioncontrasting

confidence: 57%

Hematologic abnormalities after COVID-19 vaccination: A large Korean population-based cohort study

Choi,

Kim,

Choi

et al. 2023

Preprint

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Adverse hematologic events have been reported after COVID-19 vaccination. The objective of this study was to investigate whether hematologic abnormalities develop after COVID-19 vaccination. Retrospective cohort analyses of data from the Korean National Health Insurance Service (KNHIS) database were conducted from July 2022 to August 2023. We randomly selected data of half of those living in Seoul City as of January 1, 2021 with their diagnostic records up to December 31, 2021. The included participants were vaccinated and nonvaccinated persons aged 20 years or older (n= 4,203,887). Hematologic abnormalities after COVID-19 vaccination were identified as nutritional anemia, hemolytic anemia, aplastic anemia, coagulation defects, and neutropenia using International Classification of Diseases, Tenth Revision codes after index date. Incidence rates of hematologic abnormalities in the vaccination group 3 months after vaccination were significantly higher than those in the nonvaccinated group: 14.79 vs. 9.59 (P<.001) for nutritional anemia, 7.83 vs. 5.00 (P<.001) for aplastic anemia, and 4.85 vs. 1.85 (P<.001) for coagulation defects. COVID-19 mRNA vaccine was associated with higher development of nutritional anemia (odds ratio [OR], 1.230 [95% CI, 1.129-1.339], P<.001) and aplastic anemia (OR, 1.242 [95% CI, 1.110-1.390], P<.001) than the viral vector vaccine. The risk of coagulation defects was increased (OR, 1.986 [95% CI, 1.523-2.589], P<.001) after vaccination, and there was no risk difference between mRNA vaccine and viral vector vaccine (OR, 1.075 [95% CI, 0.936-1.233], P=.306). In conclusions, COVID-19 vaccination increased the risk of hematologic abnormalities. When administering the COVID-19 vaccine, careful observation will be necessary after vaccination.

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Section: Discussioncontrasting

confidence: 57%

Hematologic abnormalities after COVID-19 vaccination: A large Korean population-based cohort study

Choi,

Kim,

Choi

et al. 2023

Preprint

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“…Treatment options given include corticosteroids, RBC transfusions and rituximab. [12] In this study, one out of the three AIHA patients did improve with administration of corticosteroids; the majority had incomplete data.…”

Section: Discussionmentioning

confidence: 69%

Hematologic adverse events reported after COVID-19 vaccination in the Philippines: A national database study

Mesina

Sapinoso

Castro³

et al. 2023

Vaccine

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“…Nevertheless, the mounting reports of these life-threatening sequelae are alarming, and further investigation of the underlying pathophysiology as well as adverse event monitoring and correlation with phenotypic associations are needed. Notably, we did not identify any reports of AIHA, thrombotic thrombocytopenic purpura, or acquired coagulation factor inhibitors in the VAERS database, all of which have been reported in association with the original formulations of the Pfizer-BioNTech and Moderna vaccines [6,7,12,13]. However, we acknowledge that one limitation of VAERS is that it is a passive reporting system, which may contribute to underreporting, therefore biasing the calculated rate and prevalence of reported conditions.…”

Section: Discussionmentioning

confidence: 93%

“…While observed following all vaccine types, VITT is most commonly associated with the Ad26.COV2.S (Johnson & Johnson/Janssen) and ChAdOx1 nCoV-19 (AstraZeneca) adenoviral vector vaccines [4]. ITP [5] and AIHA [6,7] have also been reported following SARS-CoV-2 vaccination, including among patients vaccinated with the mRNA-1273 (Moderna) and BNT162b2 (Pfizer-BioNTech) vaccines at low rates.…”

Section: Introductionmentioning

confidence: 99%

Analysis of hematologic adverse events reported to a national surveillance system following COVID-19 bivalent booster vaccination

2023

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Hematologic complications, including vaccine-induced immune thrombotic thrombocytopenia (VITT), immune thrombocytopenia (ITP), and autoimmune hemolytic anemia (AIHA), have been associated with the original severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. However, on August 31, 2022, new formulations of the Pfizer-BioNTech and Moderna vaccines were approved for use without clinical trial testing. Thus, any potential adverse hematologic effects with these new vaccines remain unknown. We queried the US Centers for Disease Control Vaccine Adverse Event Reporting System (VAERS), a national surveillance database, through February 3, 2023, all reported hematologic adverse events that occurred within 42 days of administration of either the Pfizer-BioNTech or Moderna Bivalent COVID-19 Booster vaccine. We included all patient ages and geographic locations and utilized 71 unique VAERS diagnostic codes pertaining to a hematologic condition as defined in the VAERS database. Fifty-five reports of hematologic events were identified (60.0% Pfizer-BioNTech, 27.3% Moderna, 7.3% Pfizer-BioNTech bivalent booster plus influenza, 5.5% Moderna bivalent booster plus influenza). The median age of patients was 66 years, and 90.9% (50/55) of reports involved a description of cytopenias or thrombosis. Notably, 3 potential cases of ITP and 1 case of VITT were identified. In one of the first safety analyses of the new SARS-CoV-2 booster vaccines, we identified few adverse hematologic events (1.05 per 1,000,000 doses), most of which could not be definitively attributed to vaccination. However, three reports of possible ITP and one report of possible VITT highlight the need for continued safety monitoring of these vaccines as their use expands and new formulations are authorized. KeywordsCOVID-19 • SARS-CoV-2 • Bivalent vaccine • Autoimmune hemolytic anemia • Immune thrombocytopenia • Vaccine-induced immune thrombotic thrombocytopenia * Jeremy W. Jacobs

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Development and exacerbation of autoimmune hemolytic anemia following COVID‐19 vaccination: A systematic review

Cited by 15 publications

References 37 publications

Hematologic abnormalities after COVID-19 vaccination: A large Korean population-based cohort study

Hematologic abnormalities after COVID-19 vaccination: A large Korean population-based cohort study

Hematologic adverse events reported after COVID-19 vaccination in the Philippines: A national database study

Analysis of hematologic adverse events reported to a national surveillance system following COVID-19 bivalent booster vaccination

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