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

International Journal of Infectious Diseases

Seung Won Lee¹  Lee Smith²  Seung Hyun Park³  Se Bee Lee⁴  Ai Koyanagi⁵  Beom Kyung Kim⁶  Jimin Hwang⁷  Min Ho Lee⁸  Young Joo Han⁹  Dong Keon Yon^1,10  Jae Il Shin^1,11  Louis Jacob^1,12  Kalthoum Tizaoui^1,13  Seung Up Kim^1,13 

[1] Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea;ICREA, Pg. Lluis Companys 23, Barcelona, Spain;Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea;Sungkyunkwan University School of Medicine, Suwon, Republic of Korea;Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea;Department of Data Science, Sejong University College of Software Convergence, Seoul, Republic of Korea;Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA;Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea;Hospital medicine center, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea;Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea;Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain;Ulsan University College of Medicine, Seoul, Republic of Korea;Yonsei University College of Medicine, Seoul, Republic of Korea;

关键词: Vaccine-induced immune thrombotic thrombocytopenia;    hepatosplenic thrombosis;    vaccine, portal vein thrombosis;    COVID-19 vaccine;    ChAdOx1 nCoV-19;   

DOI  :  

来源: DOAJ

【 摘 要 】

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 (13,000 vs. 29,500/μL, 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.

【 授权许可】

Unknown