Clinical significance of hepatosplenic thrombosis in vaccine-induced immune thrombotic thrombocytopenia after ChAdOx1 nCoV-19 vaccination
Por:
Hwang J, Han YJ, Yon DK, Lee SW, Kim BK, Lee SB, Lee MH, Park SH, Koyanagi A, Jacob L., Tizaoui K, Kim SU, Shin JI and Smith L
Publicada:
1 mar 2022
Ahead of Print:
24 dic 2021
Resumen:
Background: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare, serious complication after adenoviral COVID-19 vaccine administration that can involve various organ systems. We aimed to investigate the clinical significance of hepatosplenic thrombosis in patients with VITT.
Methods: We searched PubMed ePubs, Scopus, Embase, and Web of Science databases for studies published until April 28, 2021, involving patients with VITT after ChAdOx1 nCoV-19 vaccination. Demographic and clinical characteristics, including laboratory measurements, were collected and compared.
Results: Four case series and three case reports involving 48 cases of VITT were included. Hepatosplenic thrombosis was present in 8 cases (17%). Patients with hepatosplenic thrombosis had lower platelet counts (13,0 0 0 vs. 29,50 0/ mu L, p = 0.016) and higher D-dimer levels (140.0 vs. 57.3 times upper limit of normal range, p = 0.028). Multiple-site thrombosis was also associated with hepatosplenic thrombosis (88% vs. 15%, p < 0.001).
Conclusions: This is the first study comparing clinical profiles of patients with VITT according to the presence of hepatosplenic thrombosis. Patients with hepatosplenic thrombosis had more severe presentations with lower platelet counts, higher D-dimer levels, and a higher rate of multiple-site thrombosis. Further studies with larger sample sizes are required to establish definitive evidence regarding the significance of hepatosplenic thrombosis in VITT. (C) 2021 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.
Filiaciones:
Hwang J:
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
Han YJ:
Hospital medicine center, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
Yon DK:
Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
Lee SW:
Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
Kim BK:
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Insititue of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea
Lee SB:
Ulsan University College of Medicine, Seoul, Republic of Korea
Lee MH:
Yonsei University College of Medicine, Seoul, Republic of Korea
Park SH:
Yonsei University College of Medicine, Seoul, Republic of Korea
Koyanagi A:
Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain
ICREA, Pg. Lluis Companys 23, Barcelona, Spain
Jacob L.:
Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-ly-Bretonneux, France
Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain
Tizaoui K:
Department of Basic Sciences, Medicine Faculty of Tunis, Tunis El Manar University, Tunis, Tunisia
Kim SU:
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
Insititue of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea
Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea.
Shin JI:
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
Smith L:
Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
Green Published, Green Accepted
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