Tags

Type your tag names separated by a space and hit enter

Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis post COVID-19 vaccination; a systematic review.
J Neurol Sci. 2021 09 15; 428:117607.JN

Abstract

INTRODUCTION

The common reported adverse effects of COVID-19 vaccination consist of the injection site's local reaction followed by several non-specific flu-like symptoms. However, rare cases of vaccine-induced immune thrombotic thrombocytopenia (VITT) and cerebral venous sinus thrombosis (CVST) after viral vector vaccines (ChAdOx1 nCoV-19 vaccine, Ad26.COV2 vaccine) have been reported. Herein we systemically reviewed the reported cases of CVST and VITT following the COVID-19 vaccination.

METHODS

This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched PubMed until May 19, 2021, and the following Keywords were used: COVID Vaccine & Neurology, AstraZeneca COVID vaccine, ChAdOx1 nCoV-19 COVID vaccine, AZD1222 COVID vaccine, Janssen COVID vaccine, Johnson & Johnson COVID vaccine, Ad26.COV2 COVID vaccine. The authors evaluated the abstracts and titles of each article for screening and inclusion. English reports about post-vaccine CVST and VITT in humans were collected.

RESULTS

Until May 19, we found 877 articles with the searched terms. We found 12 articles, which overall present clinical features of 36 patients with CVST and VITT after the ChAdOx1 nCoV-19 vaccine. Moreover, two articles were noted, which present 13 patients with CVST and VITT after Ad26.COV2 vaccine. The majority of the patients were females. Symptom onset occurred within one week after the first dose of vaccination (Range 4-19 days). Headache was the most common presenting symptom. Intracerebral hemorrhage (ICH) and/or Subarachnoid hemorrhage (SAH) were reported in 49% of the patients. The platelet count of the patients was between 5 and 127 cells×109/l, PF4 IgG Assay and d-Dimer were positive in the majority of the reported cases. Among 49 patients with CVST, at least 19 patients died (39%) due to complications of CVST and VITT.

CONCLUSION

Health care providers should be familiar with the clinical presentations, pathophysiology, diagnostic criteria, and management consideration of this rare but severe and potentially fatal complication of the COVID-19 vaccination. Early diagnosis and quick initiation of the treatment may help to provide patients with a more favorable neurological outcome.

Authors+Show Affiliations

Department of Neurology and Neurosurgery, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada; Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.Department of Pathology and Laboratory Medicine, St Paul's Hospital, University of British Columbia (UBC), Vancouver, British Columbia, Canada.Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.Department of Medicine, Eisenhower Medical Center, Rancho Mirage, CA, USA.Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, CA, USA. Electronic address: mowla@usc.edu.

Pub Type(s)

Journal Article
Review
Systematic Review

Language

eng

PubMed ID

34365148

Citation

Sharifian-Dorche, Maryam, et al. "Vaccine-induced Immune Thrombotic Thrombocytopenia and Cerebral Venous Sinus Thrombosis Post COVID-19 Vaccination; a Systematic Review." Journal of the Neurological Sciences, vol. 428, 2021, p. 117607.
Sharifian-Dorche M, Bahmanyar M, Sharifian-Dorche A, et al. Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis post COVID-19 vaccination; a systematic review. J Neurol Sci. 2021;428:117607.
Sharifian-Dorche, M., Bahmanyar, M., Sharifian-Dorche, A., Mohammadi, P., Nomovi, M., & Mowla, A. (2021). Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis post COVID-19 vaccination; a systematic review. Journal of the Neurological Sciences, 428, 117607. https://doi.org/10.1016/j.jns.2021.117607
Sharifian-Dorche M, et al. Vaccine-induced Immune Thrombotic Thrombocytopenia and Cerebral Venous Sinus Thrombosis Post COVID-19 Vaccination; a Systematic Review. J Neurol Sci. 2021 09 15;428:117607. PubMed PMID: 34365148.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis post COVID-19 vaccination; a systematic review. AU - Sharifian-Dorche,Maryam, AU - Bahmanyar,Mohammad, AU - Sharifian-Dorche,Amirhossein, AU - Mohammadi,Pegah, AU - Nomovi,Masood, AU - Mowla,Ashkan, Y1 - 2021/08/03/ PY - 2021/05/20/received PY - 2021/07/05/revised PY - 2021/08/01/accepted PY - 2021/8/9/pubmed PY - 2021/9/7/medline PY - 2021/8/8/entrez KW - Ad26.COV2 vaccine KW - Cerebral venous sinus thrombosis KW - ChAdOx1 nCoV-19 vaccine KW - Vaccine-induced immune thrombotic thrombocytopenia SP - 117607 EP - 117607 JF - Journal of the neurological sciences JO - J Neurol Sci VL - 428 N2 - INTRODUCTION: The common reported adverse effects of COVID-19 vaccination consist of the injection site's local reaction followed by several non-specific flu-like symptoms. However, rare cases of vaccine-induced immune thrombotic thrombocytopenia (VITT) and cerebral venous sinus thrombosis (CVST) after viral vector vaccines (ChAdOx1 nCoV-19 vaccine, Ad26.COV2 vaccine) have been reported. Herein we systemically reviewed the reported cases of CVST and VITT following the COVID-19 vaccination. METHODS: This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched PubMed until May 19, 2021, and the following Keywords were used: COVID Vaccine & Neurology, AstraZeneca COVID vaccine, ChAdOx1 nCoV-19 COVID vaccine, AZD1222 COVID vaccine, Janssen COVID vaccine, Johnson & Johnson COVID vaccine, Ad26.COV2 COVID vaccine. The authors evaluated the abstracts and titles of each article for screening and inclusion. English reports about post-vaccine CVST and VITT in humans were collected. RESULTS: Until May 19, we found 877 articles with the searched terms. We found 12 articles, which overall present clinical features of 36 patients with CVST and VITT after the ChAdOx1 nCoV-19 vaccine. Moreover, two articles were noted, which present 13 patients with CVST and VITT after Ad26.COV2 vaccine. The majority of the patients were females. Symptom onset occurred within one week after the first dose of vaccination (Range 4-19 days). Headache was the most common presenting symptom. Intracerebral hemorrhage (ICH) and/or Subarachnoid hemorrhage (SAH) were reported in 49% of the patients. The platelet count of the patients was between 5 and 127 cells×109/l, PF4 IgG Assay and d-Dimer were positive in the majority of the reported cases. Among 49 patients with CVST, at least 19 patients died (39%) due to complications of CVST and VITT. CONCLUSION: Health care providers should be familiar with the clinical presentations, pathophysiology, diagnostic criteria, and management consideration of this rare but severe and potentially fatal complication of the COVID-19 vaccination. Early diagnosis and quick initiation of the treatment may help to provide patients with a more favorable neurological outcome. SN - 1878-5883 UR - https://www.unboundmedicine.com/medline/citation/34365148/Vaccine_induced_immune_thrombotic_thrombocytopenia_and_cerebral_venous_sinus_thrombosis_post_COVID_19_vaccination L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(21)00301-4 DB - PRIME DP - Unbound Medicine ER -