Vaccines against Covid-19, venous thromboembolism, and thrombocytopenia. A population-based retrospective cohort study

Laporte, Joan‐Ramon; Coma, Ermengol; Fina, Francesc; Garcı́a-Eroles, Luis; Vidal, Xavier; Medina, Manuel

doi:10.1101/2021.07.23.21261036

Cited by 4 publications

(9 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…VITT is characterised by thrombosis and thrombocytopenia that develops 4–30 days after initial vaccination with ChAdOx1nCoV-19 (AstraZeneca), Ad26.COV2.S (Janssen), BNT162b2 (Pfizer-BioNTech) or mRNA-123 (Moderna) 1–11 15 16. Three independent case series of 39 patients with VITT were initially described in the New England Journal of Medicine associated with the ChAdOx1 nCoV-19 vaccine 1–3.…”

Section: Discussionmentioning

confidence: 99%

“…She was alert and her neurological examination was normal. Blood tests demonstrated a low platelet count of 19×10 9 /L, raised D-dimer >20 mg/L and CRP of 71 mg/L (table 1). The heparin/anti-PF4 antibody assay (Stago AsserachromHPIA-IgG) was strongly positive.…”

Section: Case Presentationmentioning

confidence: 99%

“…Many of these patients had thrombosis at unusual sites such as cerebral venous sinuses or in the portal, splanchnic or hepatic veins. Other patients presented with deep venous thrombi, pulmonary emboli or acute arterial thromboses 1–11. We present a case of VITT with cerebral venous sinus thromboses followed rapidly by bilateral internal carotid artery thromboses requiring emergent mechanical clot extraction.…”

Section: Introductionmentioning

confidence: 96%

“…A new syndrome (vaccine-induced immune thrombotic thrombocytopenia, VITT) has been described characterised by thrombosis and thrombocytopenia that develops 4-30 days after initial vaccination with several COVID-19 vaccines including ChAdOx1nCoV-19 (AstraZeneca), Ad26.COV2.S (Janssen), BNT162b2 (Pfizer-BioNTech) and mRNA-123 (Moderna). [1][2][3][4][5][6][7][8][9][10][11] Many of these patients had thrombosis at unusual sites such as cerebral venous sinuses or in the portal, splanchnic or hepatic veins. Other patients presented with deep venous thrombi, pulmonary emboli or acute arterial thromboses.…”

Section: Introductionmentioning

confidence: 99%

“…Other patients presented with deep venous thrombi, pulmonary emboli or acute arterial thromboses. [1][2][3][4][5][6][7][8][9][10][11] We present a case of VITT with cerebral venous sinus thromboses followed rapidly by bilateral internal carotid artery thromboses requiring emergent mechanical clot extraction. This case illustrates the rapid progression of cerebrovascular thrombosis in VITT involving both arterial and venous systems, requiring mechanical thrombectomy in addition to medical treatment.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Cerebral arterial and venous thrombosis due to COVID-19 vaccine-induced immune thrombotic thrombocytopenia

et al. 2022

View full text Add to dashboard Cite

Vaccine-induced immune thrombotic thrombocytopenia (VITT) rarely develops after many COVID-19 vaccines. A 51-year-old woman re-presented to hospital with a 4 day history of headache, vomiting, diarrhoea and left calf pain, 11 days after her first dose of ChAdOx1nCoV-19 (AstraZenica) vaccine. Her neurological examination was normal. Blood tests demonstrated a low platelet count, raised D-dimer and CRP, and a positive heparin/anti-PF4 antibody assay. CT venogram demonstrated widespread cerebral venous sinus thrombosis. She was commenced on fondaparinux and intravenous immunoglobulins. The following day she developed an asymmetric quadriplegia and aphasia. CT angiogram demonstrated new bilateral cervical internal carotid artery (ICA) thrombi. She underwent stent-retriever mechanical thrombectomy of bilateral ICA and cerebral venous sinuses. Next day she had right hemiparesis and expressive dysphasia, which are improving. Thromboses due to VITT can progress rapidly to involve cerebral arteries and venous sinuses, and may warrant urgent arterial and venous thrombectomy to reduce morbidity and mortality.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Case Presentationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cerebral arterial and venous thrombosis due to COVID-19 vaccine-induced immune thrombotic thrombocytopenia

et al. 2022

View full text Add to dashboard Cite

show abstract

Risk of thrombosis with thrombocytopenia syndrome after COVID‐19 vaccination prior to the recognition of vaccine‐induced thrombocytopenia and thrombosis: A self‐controlled case series study in England

Higgins¹,

Andrews²,

Stowe³

et al. 2022

Research and Practice in Thrombosis and Haemostasis

View full text Add to dashboard Cite

Background Several studies have found increased risks of thrombosis with thrombocytopenia syndrome (TTS) following the ChAdOx1 vaccination. However, case ascertainment is often incomplete in large electronic health record (EHR)‐based studies. Objectives To assess for an association between clinically validated TTS and COVID‐19 vaccination. Methods We used the self‐controlled case series method to assess the risks of clinically validated acute TTS after a first COVID‐19 vaccine dose (BNT162b2 or ChAdOx1) or severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. Case ascertainment was performed uninformed of vaccination status via a retrospective clinical review of hospital EHR systems, including active ascertainment of thrombocytopenia. Results One hundred seventy individuals were admitted to the hospital for a TTS event at the study sites between January 1 and March 31, 2021. A significant increased risk (relative incidence [RI], 5.67; 95% confidence interval [CI], 1.02‐31.38) of TTS 4 to 27 days after ChAdOx1 was observed in the youngest age group (18‐ to 39‐year‐olds). No other period had a significant increase, although for ChAdOx1 for all ages combined the RI was >1 in the 4‐ to 27‐ and 28‐ to 41‐day periods (RI, 1.52; 95% CI, 0.88‐2.63; and (RI, 1.70; 95% CI, 0.73‐3.8, respectively). There was no significant increased risk of TTS after BNT162b2 in any period. Increased risks of TTS following a positive SARS‐CoV‐2 test occurred across all age groups and exposure periods. Conclusions We demonstrate an increased risk of TTS in the 4 to 27 days following COVID‐19 vaccination, particularly for ChAdOx1. These risks were lower than following SARS‐CoV‐2 infection. An alternative vaccine may be preferable in younger age groups in whom the risk of postvaccine TTS is greatest.

show abstract

Expert review on global real-world vaccine effectiveness against SARS-CoV-2

Chuenkitmongkol¹,

Solante

Burhan

et al. 2022

Expert Review of Vaccines

View full text Add to dashboard Cite

IntroductionCOVID-19 vaccines have been highly effective in reducing morbidity and mortality during the pandemic. While primary series vaccination rates are generally high in Southeast Asian (SEA) countries, various factors have limited the rollout and impact of booster doses. Areas coveredWe reviewed 79 studies in the publicly available International Vaccine Access Center (IVAC) VIEW-hub platform on vaccine effectiveness (VE) after primary immunizations with two-dose schedules. VE data were reported for SARS-CoV-2 infection, COVID-19-related hospitalizations and deaths, and strati ed across variants of concern (VOC), age, study design and prior SARS-CoV-2 infection for mRNA vaccines (BNT162b2, mRNA-1273 and combinations of both), vector vaccines (AstraZeneca, AZD1222 "Vaxzevria") and inactivated virus vaccines (CoronaVac). Expert opinionThe most-studied COVID-19 vaccines provide consistently high (>90%) protection against serious clinical outcomes like hospitalizations and deaths, regardless of variant. Additionally, this protection appears equivalent for mRNA vaccines and vector vaccines like AZD1222, as supported by our analysis of local Asian and relevant international data, and by insights from SEA experts. Given the continued impact of COVID-19 hospitalizations and deaths on healthcare systems worldwide, encouraging vaccination strategies that can reduce this burden is more relevant than attempting to prevent broader but milder infections with speci c variants, including Omicron. Article highlights-VE was high and comparable for both AZD1222 and mRNA vaccine types (91%-93%) in protecting against hospitalization and death from COVID-19, regardless of age.-VE against symptomatic infections trended higher (though not signi cantly) for mRNA-based vaccines compared to AZD1222.-Waning of VE since time of vaccination was observed for symptomatic infections but was limited for serious COVID-19 outcomes. A sub-analysis of studies with comparative arms evaluating the VE of different vaccines in the same settings also con rmed these observations for all VOC assessed, with all vaccines conferring a high level of protection against serious outcomes.-For Omicron, there is limited comparative data within the IVAC dataset, however, expert review of emerging data suggests that VE against all outcomes is lower for all COVID-19 vaccines, than for the Delta variant.-Data from the UK indicate that VE improves with a booster dose and that VE continues to be very similar, irrespective of the type of vaccine used.-Importantly, all COVID-19 vaccines evaluated here have favorable bene t/risk pro les.-Although many SEA countries have high rates of primary vaccination, there are still challenges to achieving high booster dose coverage. The results of this analysis suggest that the most effective way to achieve vaccine booster targets, particularly in resource-limited settings, would simply be to consider any vaccines which have good safety and comparable effectiveness pro les, particularly against severe outcomes, and that are accessi...

show abstract

Vaccines against Covid-19, venous thromboembolism, and thrombocytopenia. A population-based retrospective cohort study

Cited by 4 publications

References 22 publications

Cerebral arterial and venous thrombosis due to COVID-19 vaccine-induced immune thrombotic thrombocytopenia

Cerebral arterial and venous thrombosis due to COVID-19 vaccine-induced immune thrombotic thrombocytopenia

Risk of thrombosis with thrombocytopenia syndrome after COVID‐19 vaccination prior to the recognition of vaccine‐induced thrombocytopenia and thrombosis: A self‐controlled case series study in England

Expert review on global real-world vaccine effectiveness against SARS-CoV-2

Contact Info

Product

Resources

About