Clinical significance of hepatosplenic thrombosis in vaccine-induced immune thrombotic thrombocytopenia after ChAdOx1 nCoV-19 vaccination

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:...

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Detalles Bibliográficos
Autores: 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, Smith L
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p20528
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=20528
https://linkinghub.elsevier.com/retrieve/pii/S1201971221012480
Access Level:acceso abierto
Palabra clave:Vaccine-induced immune thrombotic
thrombocytopenia
hepatosplenic thrombosis
vaccine, portal vein thrombosis
COVID-19 vaccine
ChAdOx1 nCoV-19
Descripción
Sumario: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.