Cerebral Vein Thrombosis With Vaccine-Induced Immune Thrombotic Thrombocytopenia.
James E. Siegler,Piers Klein,Shadi Yaghi,Nicholas Vigilante,Mohamad Abdalkader,Jonathan M. Coutinho,Feras Abdul Khalek,Thanh N. Nguyen +7 more
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TLDR
The vaccine-induced immune thrombocytopenia and anti-PF4 (antibodies directed against platelet factor 4) were reported in 17 patients out of 7.98 million recipients of the Ad26.COV2.S vaccine.Abstract:
In the spring of 2021, reports of rare and unusual venous thrombosis in association with the ChAdOx1 and Ad26.COV2.S adenovirus-based coronavirus vaccines led to a brief suspension of their use by several countries. Thromboses in the cerebral and splanchnic veins among patients vaccinated in the preceding 4 weeks were described in 17 patients out of 7.98 million recipients of the Ad26.COV2.S vaccine (with 3 fatalities related to cerebral vein thrombosis) and 169 cases of cerebral vein thrombosis among 35 million ChAdOx1 recipients. Events were associated with thrombocytopenia and anti-PF4 (antibodies directed against platelet factor 4), leading to the designation vaccine-induced immune thrombotic thrombocytopenia. Unlike the related heparin-induced thrombotic thrombocytopenia, with an estimated incidence of <1:1000 patients treated with heparin, and a mortality rate of 25%, vaccine-induced immune thrombotic thrombocytopenia has been reported in 1:150 000 ChAdOx1 recipients and 1:470 000 Ad26.COV.2 recipients, with a reported mortality rate of 20% to 30%. Early recognition of this complication should prompt testing for anti-PF4 antibodies and acute treatment targeting the autoimmune and prothrombotic processes. Intravenous immunoglobulin (1 g/kg for 2 days), consideration of plasma exchange, and nonheparin anticoagulation (argatroban, fondaparinux) are recommended. In cases of cerebral vein thrombosis, one should monitor for and treat the known complications of venous congestion as they would in patients without vaccine-induced immune thrombotic thrombocytopenia. Now that the Ad26.COV2.S has been reapproved for use in several countries, it remains a critical component of our pharmacological armamentarium in stopping the spread of the human coronavirus and should be strongly recommended to patients. At this time, the patient and community-level benefits of these two adenoviral vaccines vastly outweigh the rare but serious risks of vaccination. Due to the relatively low risk of severe coronavirus disease 2019 (COVID-19) in young women (<50 years), it is reasonable to recommend an alternative vaccine if one is available. Ongoing postmarketing observational studies are important for tracking new vaccine-induced immune thrombotic thrombocytopenia cases and other rare side effects of these emergent interventions.read more
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Adenovirus-based vaccines—a platform for pandemic preparedness against emerging viral pathogens
TL;DR: In this paper , replication-defective adenoviral (Ad) vectors have demonstrated their utility as an outbreak-responsive vaccine platform during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.
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Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality
Thanh N. Nguyen,Muhammad M. Qureshi,Piers Klein,Hiroshi Yamagami,Mohamad Abdalkader,Robert Mikulik,Anvitha Sathya,Ossama Mansour,Anna Członkowska,Hannah C Lo,Thalia S. Field,Andreas Charidimou,Soma Banerjee,Shadi Yaghi,James E. Siegler,Petra Sedova,Joseph Kwan,Diana Aguiar de Sousa,Jelle Demeestere,Violiza Inoa,Setareh Salehi Omran,Liqun Zhang,Patrik Michel,Davide Strambo,João Marto,Raul G Nogueira +25 more
TL;DR: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year, and a CO VID-19 diagnosis was associated with higher CVt in- hospital mortality.
Journal ArticleDOI
Vaccine-Induced Immune Thrombotic Thrombocytopenia with Concurrent Arterial and Venous Thrombi Following Ad26.COV2.S Vaccination.
Andreas Charidimou,Shilpa Samudrala,Anna M. Cervantes-Arslanian,J. Mark Sloan,Hormuzdiyar H. Dasenbrock,Ali Daneshmand +5 more
Journal ArticleDOI
SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia
TL;DR: A rare but severe complication after vaccination of adenoviral vector vaccines has attracted worldwide attention as mentioned in this paper , which is characterized by thrombosis at unusual sites (often cerebral or abdominal) and the presence of antibodies against platelet factor 4 (PF4).
References
More filters
Journal ArticleDOI
Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine.
Fernando P. Polack,Stephen J. Thomas,Nicholas Kitchin,Judith Absalon,Alejandra Gurtman,Stephen Lockhart,John L. Perez,Gonzalo Pérez Marc,Edson D. Moreira,Cristiano Zerbini,Ruth Bailey,Kena A. Swanson,Satrajit Roychoudhury,Kenneth Koury,Ping Li,Warren Kalina,David A. Cooper,Robert W. Frenck,Laura L. Hammitt,Özlem Türeci,Haylene Nell,Axel Schaefer,Serhat Ünal,Dina B. Tresnan,Susan Mather,Philip R. Dormitzer,Ugur Sahin,Kathrin U. Jansen,William C. Gruber +28 more
TL;DR: A two-dose regimen of BNT162b2 conferred 95% protection against Covid-19 in persons 16 years of age or older and safety over a median of 2 months was similar to that of other viral vaccines.
Journal ArticleDOI
An interactive web-based dashboard to track COVID-19 in real time.
TL;DR: The outbreak of the 2019 novel coronavirus disease (COVID-19) has induced a considerable degree of fear, emotional stress and anxiety among individuals around the world.
Journal ArticleDOI
Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK.
Merryn Voysey,Clemens Sac.,Shabir A. Madhi,Lily Yin Weckx,P M Folegatti,Parvinder K. Aley,Brian Angus,Vicky L. Baillie,Shaun Barnabas,Q E Bhorat,S Bibi,Carmen Briner,P Cicconi,Andrea M. Collins,R Colin-Jones,Clare L. Cutland,Thomas C. Darton,Keertan Dheda,Duncan Cja.,Emary Krw.,Katie J. Ewer,Lee Fairlie,Saul N. Faust,Shuo Feng,Daniela M. Ferreira,Adam Finn,Anna Goodman,Catherine M. Green,Christopher A Green,Paul T. Heath,Christopher Hill,Helen Hill,Ian Hirsch,Hodgson Shc.,Allen Izu,S Jackson,D Jenkin,Joe Ccd.,S Kerridge,Anthonet Koen,Gaurav Kwatra,Rajeka Lazarus,Alison M. Lawrie,A Lelliott,Vincenzo Libri,Patrick J. Lillie,R Mallory,Mendes Ava.,Eveline Pipolo Milan,Angela M. Minassian,Alastair McGregor,Hazel Morrison,Y Mujadidi,Amit J Nana,P J O’Reilly,S D Padayachee,A Pittella,E Plested,Katrina M Pollock,M N Ramasamy,S Rhead,Alexandre Vargas Schwarzbold,Nisha Singh,Andrew Smith,R Song,Matthew D. Snape,Eduardo Sprinz,Rebecca K. Sutherland,R Tarrant,E. Thomson,M E Török,Mark Toshner,Turner Dpj.,Johan Vekemans,Tonya Villafana,Watson Mee.,C J Williams,Alexander D. Douglas,Hill Avs.,Teresa Lambe,Sarah C. Gilbert,Andrew J. Pollard +81 more
TL;DR: ChAdOx1 nCoV-19 has an acceptable safety profile and has been found to be efficacious against symptomatic COVID-19 in this interim analysis of ongoing clinical trials.
Journal ArticleDOI
Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine.
Lindsey R. Baden,Hana M. El Sahly,Brandon Essink,Karen L. Kotloff,Sharon E. Frey,Rick Novak,David Diemert,Stephen A. Spector,Nadine Rouphael,C. Buddy Creech,John W McGettigan,Shishir Khetan,Nathan Segall,Joel Solis,Adam Brosz,Carlos Fierro,Howard J. Schwartz,Kathleen M. Neuzil,Lawrence Corey,Peter B. Gilbert,Holly Janes,Dean Follmann,Mary A. Marovich,John R. Mascola,Laura Polakowski,Julie E. Ledgerwood,Barney S. Graham,Hamilton Bennett,Rolando Pajon,Conor Knightly,Brett Leav,Weiping Deng,Honghong Zhou,Shu Liang Han,Melanie Ivarsson,Jacqueline Miller,Tal Z Zaks +36 more
TL;DR: The mRNA-1273 vaccine as discussed by the authors is a lipid nanoparticle-encapsulated mRNA-based vaccine that encodes the prefusion stabilized full-length spike protein of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes Covid-19.
Journal ArticleDOI
BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Mass Vaccination Setting.
Noa Dagan,Noam Barda,Noam Barda,Noam Barda,Eldad Kepten,Oren Miron,Oren Miron,Shay Perchik,Mark A. Katz,Mark A. Katz,Mark A. Katz,Miguel A. Hernán,Marc Lipsitch,Ben Y. Reis,Ran D. Balicer,Ran D. Balicer +15 more
TL;DR: This study in a nationwide mass vaccination setting suggests that the BNT162b2 mRNA vaccine is effective for a wide range of Covid-19–related outcomes, a finding consistent with that of the randomized trial.