Thrombotic events following Covid-19 vaccines compared to Influenza vaccines

Vallone, Marcelo; Falcón, Andre Luis; Castro, Horacio Matías; Ferraris, Augusto; Cantarella, Ramiro F; Staneloni, María Inés; Aliperti, Valeria; Ferloni, Analía; Mezzarobba, M.; Vázquez, Fernando Javier; Ratti, María Florencia Grande

doi:10.1016/j.ejim.2022.03.002

Cited by 14 publications

(13 citation statements)

References 20 publications

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“…Studies, and Registry-Based Studies Two RCTs, 3 cohort studies, and 11 registry-based studies that reported on 17,481 ischemic strokes following 782,989,363 COVID-19 vaccinations were included in the systematic review and subsequent meta-analysis. 15,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] Both RCTs were assigned as low risk of bias (eFigure 1, links.lww.com/WNL/C239). The risk of bias in the included cohort and registry-based studies was assessed by the Newcastle-Ottawa scale and is presented in eTable 3.…”

Section: Randomized Controlled Clinical Trials Cohortmentioning

confidence: 99%

Acute Arterial Ischemic Stroke Following COVID-19 Vaccination

et al. 2022

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Background:Acute arterial-ischemic-stroke (AIS) has been reported as a rare adverse-event following COVID-19-vaccination with mRNA or viral-vector vaccines. However, data are sparse regarding the risk of post-vaccination AIS and its potential association with thrombotic-thrombocytopenia-syndrome (TTS).Methods:A systematic review and meta-analysis of randomized-controlled clinical trials (RCTs), pharmacovigilance registries, registry-based studies, observational cohorts and case-series was performed with the aim to calculate: (1) the pooled proportion of patients presenting with AIS following COVID-19-vaccination; (2) the prevalence of AIS after mRNA and vector-based vaccination; (3) the proportion of TTS among post-vaccination AIS-cases. Patient characteristics were assessed as secondary outcomes.Results:Two RCTs, three cohort and eleven registry-based studies comprising 17,481 AIS-cases among 782,989,363 COVID-19-vaccinations were included in the meta-analysis. The pooled proportion of AIS following exposure to any COVID-19-vaccine type was 4.7 cases per 100,000 vaccinations (95%CI:2.2-8.1; I2=99.9%). The pooled proportion of AIS following mRNA-vaccination (9.2 cases per 100,000 vaccinations; 95%CI: 2.5-19.3; I2=99.9%) did not differ compared to adenovirus-based-vaccination (2.9 cases per 100,000 vaccinations; 95%CI: 0.3-7.8; I2=99.9%). No differences regarding demographics were disclosed between patients with AIS following mRNA- or vector-based vaccination. The pooled proportion of TTS among post-vaccination AIS-cases was 3.1% (95%CI: 0.7-7.2%; I2=78.8%).Conclusions:The pooled proportion of AIS following COVID-19 vaccination is comparable to the prevalence of AIS in the general population and much lower than the AIS prevalence among SARS-CoV-2-infected patients. TTS is very uncommonly reported in patients with AIS following COVID-19 vaccination.

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Section: Randomized Controlled Clinical Trials Cohortmentioning

confidence: 99%

Acute Arterial Ischemic Stroke Following COVID-19 Vaccination

et al. 2022

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“…Moreover, efficacies of BBIBP-CorV against symptomatic infection and hospitalization were both 79%, according to WHO [ 56 ]. Although common side effects of these two vaccines are mild to moderate [ 57 , 58 ], there are rare cases of thrombotic events [ [59] , [60] , [61] , [62] ]. As presented in Table 3 , we found 2 articles including 4 patients (3 CoronaVac and 1 BBIBP-CorV) with AIS after inactivated virus vaccine administration.…”

Section: Resultsmentioning

confidence: 99%

Acute ischemic stroke and vaccine-induced immune thrombotic thrombocytopenia post COVID-19 vaccination; a systematic review

Kolahchi

Khanmirzaei

Mowla

2022

Journal of the Neurological Sciences

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“…The risk of COVID-19 worsening is thought to be higher than the risk of adverse effects after vaccination. In contrast, a report comparing thrombotic events after influenza vaccination to those after SARS-CoV-2 vaccination showed a significant increase in thrombotic events after COVID-19 vaccination [48]. More rigorous follow-up after vaccination is needed and it is important to detect symptomatic cases early on to allow for early treatment.…”

Section: Discussionmentioning

confidence: 99%

Histopathologically TMA-like distribution of multiple organ thromboses following the initial dose of the BNT162b2 mRNA vaccine (Comirnaty, Pfizer/BioNTech): an autopsy case report

et al. 2022

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Background Coronavirus disease 2019 (COVID-19) has spread worldwide. Vaccination is now recommended as one of the effective countermeasures to control the pandemic or prevent the worsening of symptoms. However, its adverse effects have been attracting attention. Here, we report an autopsy case of multiple thromboses after receiving the first dose of the BNT162b2 mRNA vaccine (Comirnaty, Pfizer/BioNTech) in an elderly woman. Case presentation A 72-year-old woman with a history of diffuse large B-cell lymphoma in the stomach and hyperthyroidism received the first dose of the BNT162b2 mRNA vaccine and died 2 days later. The autopsy revealed multiple microthrombi in the heart, brain, liver, kidneys, and adrenal glands. The thrombi were CD61 and CD42b positive and were located in the blood vessels primarily in the pericardial aspect of the myocardium and subcapsular region of the adrenal glands; their diameters were approximately 5–40 μm. Macroscopically, a characteristic myocardial haemorrhage was observed, and the histopathology of the characteristic thrombus distribution, which differed from that of haemolytic uraemic syndrome and disseminated intravascular coagulation, suggested that the underlying pathophysiology may have been similar to that of thrombotic microangiopathy (TMA). Conclusion This is the first report on a post-mortem case of multiple thromboses after the BNT162b2 mRNA vaccine. The component thrombus and characteristic distribution of the thrombi were similar to those of TMA, which differs completely from haemolytic uraemic syndrome or disseminated intravascular coagulation, after vaccination. Although rare, it is important to consider that fatal adverse reactions may occur after vaccination and that it is vital to conduct careful follow-up.

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Thrombotic events following Covid-19 vaccines compared to Influenza vaccines

Cited by 14 publications

References 20 publications

Acute Arterial Ischemic Stroke Following COVID-19 Vaccination

Acute Arterial Ischemic Stroke Following COVID-19 Vaccination

Acute ischemic stroke and vaccine-induced immune thrombotic thrombocytopenia post COVID-19 vaccination; a systematic review

Histopathologically TMA-like distribution of multiple organ thromboses following the initial dose of the BNT162b2 mRNA vaccine (Comirnaty, Pfizer/BioNTech): an autopsy case report

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