Understanding vaccine‐induced thrombotic thrombocytopenia (VITT)

Dix, Caroline; McFadyen, James D.; Huang, Angela; Chunilal, Sanjeev; Chen, Vivien; Tran, Huyen

doi:10.1111/imj.15783

Cited by 13 publications

(10 citation statements)

References 28 publications

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“…As for the mechanisms by which an adenoviral vector vaccine may cause ITT, it has been hypothesized that there may be a reaction between the cationic PF4 and the anionic free DNA contained in the recombinant vaccine ( 45 , 125 ). However, the underlying pathways by which COVID-19 vaccination may stimulate anti-PF4 antibody production need further examination.…”

Section: Discussionmentioning

confidence: 99%

Endocrine system after 2 years of COVID-19 vaccines: A narrative review of the literature

et al. 2022

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PurposeThe purpose of this study was to describe the current knowledge on the potential endocrine adverse effects post-COVID-19 vaccines.MethodsA PubMed/MEDLINE, Web of Science, and Scopus research was performed. Case reports, case series, original studies, and reviews written in English and published online up to 31 July 2022 were selected and reviewed. The final reference list was defined based on the relevance of each paper to the scope of this review.ResultsThe available data showed that endocrine side effects are generally rare and with favorable outcome, being thyroid disorders the most common. Conversely, data on type 1 diabetes mellitus are rare; adrenal and pituitary events are even anecdotal. Finally, the available clinical studies suggest no impact on female reproductive system and on male and couple fertility.ConclusionOverall, these data show that, after 2 years of COVID-19 vaccines, the endocrine system is not heavily threatened.

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Section: Discussionmentioning

confidence: 99%

Endocrine system after 2 years of COVID-19 vaccines: A narrative review of the literature

et al. 2022

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“…VITT is associated with elevated D-dimer and elevated anti-PF-4 antibodies. It is frequently complicated by thrombosis, including VST (Dix et al, 2022). About half of the patients with VITT experience a VST (Palaiodimou et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 vaccination associated venous sinus thrombosis in three patients

Finsterer¹

2022

JAB

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Introduction: There is increasing evidence that vaccinations against the severe acquired respiratory syndrome coronavirus type-2 (SARS-CoV-2) virus can be followed by venous sinus thrombosis (VST). Here we report on three patients who developed VST shortly after SARS-CoV-2 vaccinations. Case series: An 80-year-old male, a 58-year-old male, and a 34-year-old female developed VST 14 to 24 days after the first dose of an mRNA-based SARS-CoV-2 vaccine. All three patients profited from analgesics, heparinisation, and oral anticoagulation, but made only an incomplete recovery at the time of discharge. Arguments for a causal relationship are: VST was time-linked to vaccination in the three patients; VST was previously reported after SARS-CoV-2 vaccination; SARS-CoV-2 infections can be complicated by VST; and SARS-CoV-2 can be associated with hypercoagulability. The fact that no hypercoagulability occurred in a pilot study after SARS-CoV-2 vaccination and that there has been no evidence of an increased prevalence/incidence of VST after vaccination since the introduction of the SARS-CoV-2 vaccination speak against a causal relationship. Conclusions: SARS-CoV-2 vaccinations can occasionally be followed by a VST. There are more arguments for than against a causal relationship.

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“…1,[36][37][38][39] Cumulatively, a few basic tenets subside in most criteria, including elevated D-dimer (> 4,000 μg/mL [fibrinogen equivalent units]), reduced fibrinogen (below the normal range), positive anti-PF4 antibodies by ELISA testing, thrombocytopenia (platelet count < 150 Â 10 9 /L), and an onset of symptoms after 4 days of adenovirus-based COVID vaccination. 40,41 Conversely, each criterion contains slight variations, mainly due to the timing of their release, influence of research based on newly reported cases, and whether they have been updated routinely. 3,32 Exemplarily was the exclusion of possible VITT cases outside of the 28-day, postvaccination period, which is now believed to be limiting to identification of prior potential cases.…”

Section: Diagnostic Criteria and Guidelinesmentioning

confidence: 99%

“…3,30,36,39 The use of ELISA assays for detecting anti-PF4 antibodies has thus far been largely accepted to confirm VITT. 40,41 In terms of reporting, however, this criterion is not yet extensively indispensable. For example, negative or obscure results for ELISA have been used in several cases.…”

Section: Diagnostic Criteria and Guidelinesmentioning

confidence: 99%

COVID-19 Vaccine-Associated Immune Thrombosis and Thrombocytopenia (VITT): Diagnostic Discrepancies and Global Implications

Zidan

Noureldin

Kumar

et al. 2023

Semin Thromb Hemost

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Vaccine-induced immune thrombotic thrombocytopenia (VITT) has been reported in association with the coronavirus disease 2019 preventative adenovirus vector-based vaccines ChAdOx1 nCoV-19 (Oxford/AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson) in hundreds of recipients across the globe. VITT is characterized by thrombosis, typically at unusual sites, low fibrinogen, and elevated plasma D-dimer, generally manifesting between 4 and 28 days following vaccination. Detection of anti-platelet factor antibodies using an enzyme-linked immunosorbent assay (ELISA) is often confirmatory. Although several similar principles subside in most diagnostic criteria for VITT, the presentation of a positive ELISA assay, use of expert hematology and neurology opinion, and exclusion of possible VITT cases outside the “standard” 4 to 28-day timeframe have contributed a lack of global standardization for defining VITT. Accordingly, the global and regional incidence of VITT differs according to the diagnostic pathway and case definition used. This has influenced the public perception of VITT's severity and the decision to use adenovirus vector-based vaccines for limiting severe acute respiratory syndrome coronavirus 2 infection. We hereby delineate the recognized pathogenic mechanisms, global incidence, discrepancies in diagnostic criteria, recommended treatments, and global implications to vaccine hesitancy from this coagulopathy.

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Understanding vaccine‐induced thrombotic thrombocytopenia (VITT)

Cited by 13 publications

References 28 publications

Endocrine system after 2 years of COVID-19 vaccines: A narrative review of the literature

Endocrine system after 2 years of COVID-19 vaccines: A narrative review of the literature

SARS-CoV-2 vaccination associated venous sinus thrombosis in three patients

COVID-19 Vaccine-Associated Immune Thrombosis and Thrombocytopenia (VITT): Diagnostic Discrepancies and Global Implications

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