<scp>COVID</scp>‐19 <scp>mRNA</scp> vaccine‐associated cerebral venous thrombosis: Rare adverse event or coincidence?

Fan, Bingwen Eugene; Ling, Ryan Ruiyang; Ramanathan, Kollengode; Leung, Bernard P.; Lim, Xin Rong; Chadachan, Veerendra; Thirugnanam, Umapathi; Stegner, David; Tu, Tian Ming

doi:10.1002/ajh.26773

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…As per the previous evidence, most adverse events following vaccination were nonserious, such as fatigue, headache, and myalgia 3 . Although rare, vaccine‐induced thrombotic complications have recently attracted extensive concern 4,5 …”

Section: Introductionmentioning

confidence: 75%

“…3 Although rare, vaccine-induced thrombotic complications have recently attracted extensive concern. 4,5 Thrombotic microangiopathy (TMA), a pathological manifestation observed in multiple diseases, is characterized by thrombocytopenia, microangiopathic hemolytic anemia, and ischemic organ damage. 6,7 Thrombotic thrombocytopenic purpura (TTP) and atypical hemolytic uremic syndrome (aHUS) are significant subtypes of TMA.…”

Section: Introductionmentioning

confidence: 99%

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New‐onset and relapsed thrombotic microangiopathy post‐COVID‐19 vaccination

2023

Journal of Medical Virology

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Thrombotic microangiopathy (TMA) associated with coronavirus disease 2019 (COVID-19) vaccination has been reported, however, the clinical characteristics and pathogenesis remained mysterious. We reviewed 84 TMA cases post-COVID-19 vaccination, including 64 patients diagnosed with thrombotic thrombocytopenic purpura (TTP), 17 cases presented as atypical hemolytic uremic syndrome (aHUS), and three cases manifested as unclassified TMA. TMA episodes were mostly associated with messenger RNA vaccines. For TTP, 67.6% of females developed symptoms after the first dose of the vaccine, and 63.0% of males were secondary to the second dose (p = 0.015). Compared with TTP, aHUS generally appeared within 7 days (p = 0.002) and showed higher levels of serum creatinine (p < 0.001). 87.5% of TTP received plasma exchange (PEX)-based treatment, and 52.9% of aHUS adopted non-PEX-based therapies (p < 0.001). Mechanistically, complement dysfunction, neutrophil activation, and the generation of pathogenic autoantibodies resulting from molecular mimicry contribute to explaining the pathogenesis of TMA post-COVID-19 vaccination.

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Section: Introductionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

New‐onset and relapsed thrombotic microangiopathy post‐COVID‐19 vaccination

2023

Journal of Medical Virology

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“…It is believed that DNA from the adenovirus-infected cells bonded to platelet factor 4 and triggered the production of autoantibodies. 79,80 Although CVT in VITT is a rare condition, 81 it carries a poor prognosis, with mortality rates ranging from 39% to 61% in initial cohort studies. 80,82,83 A study on the global impact of COVID-19 that included 2313 CVT admissions across 1 prepandemic year (2019) and 1 pandemic year (2020) found 26 cases of VITT, resulting in 6 deaths.…”

Section: Vitt and Cvtmentioning

confidence: 99%

Diagnosis and Management of Cerebral Venous Thrombosis: A Scientific Statement From the American Heart Association

Saposnik,

Bushnell,

Coutinho

et al. 2024

Stroke

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Cerebral venous thrombosis accounts for 0.5% to 3% of all strokes. The most vulnerable populations include young individuals, women of reproductive age, and patients with a prothrombotic state. The clinical presentation of cerebral venous thrombosis is diverse (eg, headaches, seizures), requiring a high level of clinical suspicion. Its diagnosis is based primarily on magnetic resonance imaging/magnetic resonance venography or computed tomography/computed tomographic venography. The clinical course of cerebral venous thrombosis may be difficult to predict. Death or dependence occurs in 10% to 15% of patients despite intensive medical treatment. This scientific statement provides an update of the 2011 American Heart Association scientific statement for the diagnosis and management of cerebral venous thrombosis. Our focus is on advances in the diagnosis and management decisions of patients with suspected cerebral venous thrombosis. We discuss evidence for the use of anticoagulation and endovascular therapies and considerations for craniectomy. We also provide an algorithm to optimize the management of patients with cerebral venous thrombosis and those with progressive neurological deterioration or thrombus propagation despite maximal medical therapy.

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“…По имеющимся данным [26], 1,92 случая на миллион доз BNT162b2; 5,63 случая на миллион доз mRNA-1273; 21,6 случая на миллион доз ChAdOx1-S/nCoV-19; 11,4 случая Janssen Ad26.COV2.S. Анализ данных подтверждает бóльшую частоту развития церебрального венозного тромбоза при введении ДНК-вакцин, чем при использовании мРНК-вакцин [27]. Эти результаты подтверждаются в исследовании немецких авторов -церебральный венозный тромбоз возникал в основном после вакцинации ChAdOx1 (85,5 %), реже после BNT162b2 (14,5 %) [28].…”

Section: нарушения гемостаза и повреждение эндотелияunclassified

SARS-CoV-2 post-vaccination adverse reports: A review

Proskurnina,

Ivanov,

Redko

2023

Vestnik SPbSU. Medicine

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Acute respiratory infection caused by the SARS-CoV-2 coronavirus was the cause of the pandemic announced in March 2020. To prevent this disease, various vaccines have been developed and introduced into mass use, including on an innovative gene platform. The aim of the review is to analyze foreign literature on post-vaccination complications with the use of foreign vaccines, as well as whole-virion vaccines for the period 2021 — January 2023. The sources used in the publication were obtained from the Medline database, as well as articles in peer-reviewed journals and official reports. Post-vaccination complications are associated with specific damage to organs or systems either directly by the vaccine itself or indirectly as a result of exacerbation of the chronic process. The pathogenesis of post-vaccination complications depends on the composition of the vaccine. All complications were grouped by organs and systems. Vaccines containing SARS-CoV-2 antigens can activate autoimmune reactions due to homology, as well as activation of existing reactions in predisposed patients, which is confirmed by the effectiveness of immunosuppressive therapy. Innovative platforms using gene technologies are so complex and profoundly active that they can be introduced into broad medical practice only after a thorough and comprehensive study of the effects and mechanisms. Scientific achievements should follow the ethical principles of healing, and above all primum non nocere. Experts around the world emphasize the need for continued monitoring of people’s condition in order to protect their health and assess the long-term safety of drugs.

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COVID‐19 mRNA vaccine‐associated cerebral venous thrombosis: Rare adverse event or coincidence?

Cited by 6 publications

References 14 publications

New‐onset and relapsed thrombotic microangiopathy post‐COVID‐19 vaccination

New‐onset and relapsed thrombotic microangiopathy post‐COVID‐19 vaccination

Diagnosis and Management of Cerebral Venous Thrombosis: A Scientific Statement From the American Heart Association

SARS-CoV-2 post-vaccination adverse reports: A review

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