Imaging and Hematologic Findings in Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 (AstraZeneca) Vaccination

Abstract

An earlier incorrect version appeared online. This article was corrected on August 18, 2021. This case series reports six patients (4 men; median age 38 years; interquartile range 26-48) presenting with vaccine-induced thrombocytopenia and thrombosis beginning 3 to 26 days after receiving the first dose of the ChAdOx1 nCoV-19 (AstraZeneca) vaccine. The patients were admitted to a general hospital between 9 to 31 days after the first dose. All patients had strongly detected anti-platelet factor 4 antibodies and severe thrombosis. Laboratory features included thrombocytopenia and elevated D-Dimer levels. Thrombotic events were predominantly venous; two patients had arterial or mixed arterial/venous thrombosis. All patients recovered after receiving intravenous immunoglobulin and non-heparin based anticoagulation.

Real‐world evidence from over one million COVID‐19 vaccinations is consistent with reactivation of the varicella‐zoster virus

“…Specifically, eosinophilic lung disease, cerebral venous sinus thrombosis (CVST), pulmonary embolism, vaccine‐induced immune thrombocytopenia (VITT) and myocarditis were found to be associated with COVID‐19 vaccination. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 …”

ChAdOx1 nCoV-19 Vaccine and Thrombosis with Thrombocytopenia Syndrome among Adults: A Systematic Review

“…Among the cases with TTS in this systematic review, about 60% had no remarkable PMH of any personal or familial disease/risk factors, and about 24% had preexisting conditions. In addition, less than 30% of the cases had several regular medications with contraceptives as the most used medication [21][22][23][24][25][26][27][28] . However, the number of cases for each condition or medication is not enough to find a relationship between the pre-existing condition or regular medication and TTS risk post-ChAdOx1 nCoV-19 vaccination.…”

“…However, the number of cases for each condition or medication is not enough to find a relationship between the pre-existing condition or regular medication and TTS risk post-ChAdOx1 nCoV-19 vaccination. In addition to the common symptoms associated with administration of ChAdOx1 nCoV-19 vaccine with headache as the most common initial symptom (>44.2%) 2,11,[21][22][23][24][25][26] , cases in this systematic review reported having some uncommon initial symptoms, including hemorrhage/thrombotic problems (22.46%) 11,24,28,52,60,61 and discoordination/weakness/numbness/hemiparesis/cyanotic toes (19.6%) [21][22][23][29][30][31][37][38][39][40][41]48,52,54,56,62,63 as the most prevalent uncommon initial symptoms which could be a signal alert to be aware of VITTS. However, further study is needed to figure out a relationship between these initial symptoms and the risk of VITTS.…”

“…However, further study is needed to figure out a relationship between these initial symptoms and the risk of VITTS. The initial symptoms were appeared within the first, second, third, fourth, and fifth week post vaccination with ChAdOx1 nCov-19 vaccine in 32.1% 2,11,21,22,24,25,[27][28][29][30][31][32]34,35,37,40,42,43,[45][46][47][48][49][50][53][54][55][56][57][58][59]62,[64][65][66][67] , 53.3% 2,11,[22][23][24][25][26][27][28][29]31,33,[36][37][38][39][40][41][42][43][44]…”

“…This systematic review also investigated the clinical features in a cohort of cases presenting with acute atypical thrombosis, mainly involving the cerebral veins and concurrent thrombocytopenia. Most cases involved in this systematic review presented with CVT/CVST 2,11,22,[24][25][26][27][28][29]33,34,36,39,45,47,54,56,58,[60][61][62]71 , SVT (thrombosis of the portal (PVT), mesenteric, splenic, ileal, or hepatic veins) 2,11,22,[24][25][26][27][28][29]31,[33][34][35][36][38][39][40]44,45,47,52,[54][55][56][57][58]61,62,65,66,69,71 , transverse sinus/cerebral thrombosis…”