COVID-19 Vaccine-Associated Thrombosis

COVID-19 Vaccine-Associated Thrombosis With Thrombocytopenia Syndrome (TTS): A Systematic Review and Post Hoc Analysis

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Muhammad Usman Hafeez, MBBS, Maha Ikram, MBBS, Zunaira Shafiq, MBBS, ...

First Published October 26, 2021 Research Article

https://doi.org/10.1177/10760296211048815

"Clinicians ought to maintain a high degree of suspicion when recently-vaccinated individuals present with headaches or other symptoms suggestive of thrombosis."

https://journals.sagepub.com/doi/10.1177/10760296211048815

Abstract

The ChAdOx1 nCoV-19 vaccine has been associated with increased risk of thrombosis. Understanding of management of these rare events is evolving, and currently recommended treatments include human normal immunoglobulin and non-heparin anticoagulation such as direct oral anticoagulants. Our report describes three consecutive patients presenting to a London teaching hospital with vaccine induced thrombotic thrombocytopenia (VITT), also referred to as vaccine-induced prothrombotic immune thrombocytopenia (VIPIT). The patients ranged in age from 40-54 years and two had no known previous medical comorbidities. Two patients had cerebral venous sinus thrombosis and one had a deep vein thrombosis. Two were treated with anticoagulation; one with oral rivaroxaban; and the other with an intravenous argotraban infusion that was later converted to oral apixaban. One patient received three doses of human normal immunoglobulin and five days of therapeutic plasma exchange. This case series may be used to improve understanding of the clinical course and management of VITT.