Journal
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
Volume 19, Issue 11, Pages 2845-2856Publisher
WILEY
DOI: 10.1111/jth.15485
Keywords
adenovirus; COVID-19 vaccine; platelet activation; thrombocytopenia; thrombosis
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VITT is a rare complication induced by COVID-19 vaccines, characterized by thrombosis and thrombocytopenia. There have been 467 reported cases of VITT globally, with the pathogenic mechanism yet to be fully elucidated. Further research is needed to solidify a pathogenic model for this condition.
Vaccine-induced immune thrombotic thrombocytopenia (VITT) has caused global concern. VITT is characterized by thrombosis and thrombocytopenia following COVID-19 vaccinations with the AstraZeneca ChAdOx1 nCov-19 and the Janssen Ad26.COV2.S vaccines. Patients present with thrombosis, severe thrombocytopenia developing 5-24 days following first dose of vaccine, with elevated D-dimer, and PF4 antibodies, signifying platelet activation. As of June 1, 2021, more than 1.93 billion COVID-19 vaccine doses had been administered worldwide. Currently, 467 VITT cases (0.000024%) have been reported across the UK, Europe, Canada, and Australia. Guidance on diagnosis and management of VITT has been reported but the pathogenic mechanism is yet to be fully elucidated. Here, we propose and discuss potential mechanisms in relation to adenovirus induction of VITT. We provide insights and clues into areas warranting investigation into the mechanistic basis of VITT, highlighting the unanswered questions. Further research is required to help solidify a pathogenic model for this condition.
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