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Article
Hematology
Linda Schoenborn et al.
Summary: In an observational study on vaccine-induced thrombotic thrombocytopenia (VITT), it was found that the platelet-activating antibodies in most patients are transient, and it is safe for VITT patients to receive a second dose of COVID-19 mRNA vaccine.
Letter
Medicine, General & Internal
Joanne Lacy et al.
Summary: Forty individuals who developed thrombosis and thrombocytopenia after initial vaccination with ChAdOx1 nCoV-19 were given a second dose of a different Covid-19 vaccine, predominantly BNT162b2, and did not experience a recurrence of thrombosis and thrombocytopenia.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Medicine, General & Internal
Merryn Voysey et al.
Summary: The ChAdOx1 nCoV-19 vaccine has been shown to have an acceptable safety profile and effectiveness against symptomatic COVID-19, with higher efficacy observed in the group that received a low dose followed by a standard dose.
Article
Hematology
Johannes Thaler et al.
Summary: Patients with vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) can achieve remission without sequelae upon rapid initiation of treatment, and platelet factor 4 antibody levels slowly decrease over several weeks, but VIPIT did not recur in any of our patients.
THROMBOSIS RESEARCH
(2021)
Article
Hematology
Thomas Thiele et al.
Summary: After vaccination with different brands of COVID-19 vaccines, some healthy vaccinees tested positive for anti-PF4/polyanion antibodies, but most of these antibodies did not induce platelet activation. Pathogenic platelet-activating antibodies causing VITT were uncommon after vaccination.
Article
Hematology
Stefan Handtke et al.
Summary: Vaccination plays a crucial role in combating the pandemic caused by the SARS-CoV-2 virus. The rare complication of thrombocytopenia and thrombotic complications after ChAdOx1 nCov-19 vaccination can be identified using a widely applicable whole-blood standard flow cytometric assay, allowing for rapid diagnosis by many laboratories.
Article
Hematology
Sean Platton et al.
Summary: Commercially available assays in the UK showed poor sensitivity for detecting anti-PF4 antibodies in suspected VITT patients when compared to ELISA testing. No superiority of IgG-ELISAs over polyspecific ELISAs in sensitivity to VITT was demonstrated, and no single ELISA method detected all possible/probable VITT cases. If a single ELISA test is negative, a second ELISA or platelet activation assay should be considered for cases with strong clinical suspicion.
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
(2021)
Article
Medicine, General & Internal
Marie Scully et al.
Summary: 23 cases of thrombotic thrombocytopenia were reported after receiving the AstraZeneca vaccine, incited by antibodies to platelet factor 4 and unrelated to heparin therapy. Avoidance of platelet transfusion and consideration of nonheparin anticoagulant and intravenous immune globulin are recommended for treatment.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Medicine, General & Internal
Nina H. Schultz et al.
Summary: This study reports five cases of venous thrombosis and thrombocytopenia occurring 7 to 10 days after receiving the ChAdOx1 nCoV-19 vaccine, suggesting a rare vaccine-induced immune thrombotic thrombocytopenia. The condition, which can lead to catastrophic outcomes such as cerebral venous sinus thrombosis, may be treated with intravenous immune globulin.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Medicine, General & Internal
Andreas Greinacher et al.
Summary: After vaccination with ChAdOx1 nCov-19, rare immune thrombotic thrombocytopenia can occur due to platelet-activating antibodies against PF4, resulting in various thrombotic events. Most patients in this case series were women, with fatal outcomes such as cerebral venous thrombosis and intracranial hemorrhage. Additional studies are needed to further investigate and understand this phenomenon.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Medicine, General & Internal
Richard J. Perry et al.
Summary: The study documented cases of cerebral venous thrombosis after COVID-19 vaccination, finding that patients with VITT were younger, had more intracranial and extracranial thrombosis, and experienced worse outcomes compared to non-VITT patients. Treatments with non-heparin anticoagulants and intravenous immunoglobulin may improve outcomes in VITT-associated cerebral venous thrombosis.
Article
Medicine, General & Internal
Sue Pavord et al.
Summary: Phenotypes of VITT were defined in 220 patients in the United Kingdom who presented a median of 14 days after the first ChAdOx1 nCoV-19 vaccination. Half had cerebral venous sinus thrombosis, a third of whom also had intracranial hemorrhage. Mortality was 22%. Intravenous immune globulin may reverse VITT.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Letter
Medicine, General & Internal
Linda Schoenborn et al.
Summary: The study found that pathogenic antibodies in VITT patients decreased after receiving adenoviral vector Covid-19 vaccines, with improvements in platelet activation despite persistent positivity on ELISA. Additionally, 5 patients received additional vaccination without any sequelae.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Review
Hematology
Theodore E. Warkentin et al.
Summary: Heparin-induced thrombocytopenia (HIT) is characterized by thrombocytopenia, hypercoagulability, and increased thrombosis risk, with platelet-activating anti-PF4/heparin antibodies. Non-heparin medications and naturally-occurring polyanions can also trigger HIT. Spontaneous HIT syndrome can occur without prior exposure to heparin or polyanionic medications. COVID-19 vaccination has been associated with a similar disorder, Vaccine-induced immune thrombotic thrombocytopenia (VITT), featuring unusual thromboses.
THROMBOSIS RESEARCH
(2021)
Article
Hematology
Noppacharn Uaprasert et al.
Summary: A study on Thai individuals vaccinated with ChAdOx1 vaccine showed a low prevalence of thrombocytopenia and pathogenic anti-PF4 Abs, with D-dimer testing revealing no significant coagulation activation. Routine tests for platelet counts, anti-PF4 Abs, and D-dimer levels are not recommended for VITT screening without clinical suspicion.
RESEARCH AND PRACTICE IN THROMBOSIS AND HAEMOSTASIS
(2021)
Review
Cell Biology
Dilli Ram Poudel et al.
Article
Hematology
Douglas Shemin et al.
JOURNAL OF CLINICAL APHERESIS
(2007)
Article
Medicine, General & Internal
TE Warkentin et al.
NEW ENGLAND JOURNAL OF MEDICINE
(2001)
