Vaccine-induced immune thrombotic thrombocytopenia after COVID-19 vaccination: Description of a series of 39 cases in Brazil

Autor: Patricia Mouta Nunes de Oliveira, Daniela P. Mendes-de-Almeida, Victor Bertollo Gomes Porto, Catherine Crespo Cordeiro, Gabriellen Vitiello Teixeira, Renata Saraiva Pedro, Paulo Roberto Gomes Takey, Letícia Kegele Lignani, Janaína Reis Xavier, Vitor Cardoso Doria da Gama, Luiz Amorim Filho, Bárbara Emoingt Furtado, André Santa Maria, Tiago Dahrug Barros, Livia Neves Waite Freitas, Tainá dos Santos Pereira, Debora Lima Abreu, Michael Bernardes Ramos, Caroline Gabe, Donald Arnold, James William Smith, Ishac Nazy, Maria de Lourdes de Sousa Maia
Rok vydání: 2022
Předmět:
Zdroj: Vaccine. 40(33)
ISSN: 1873-2518
Popis: Describe a case series of vaccine-induced immune thrombotic thrombocytopenia (VITT) after COVID-19 vaccination in Brazil that included ChAdOx1 nCoV-19, Ad26.COV2.S and BNT162b2 vaccines, describing their clinical and laboratory characteristics.Descriptive case series study using Bio-Manguinhos/Fiocruz/AstraZeneca Brazil and National Immunization Program/Ministry of Health (NIP/MoH) data on COVID-19 AEFI surveillance. We obtained patient-level data from pharmacovigilance for AEFI surveillance and used both the NIP/MoH and Bio-Manguinhos/Fiocruz pharmacovigilance databases to create the study database. Thirty-nine cases of suspect VITT were included, 36 after ChAdOx1 nCoV-19, one after BNT162b2 and two after Ad26.COV2.S vaccine. All cases were based on meeting the Brighton Collaboration criteria for VITT. The primary outcomes were clinical and laboratory features, site of thrombosis, and anti-PF4 ELISA, when available.Thirty-nine cases met the criteria, 38 of which were classified as level 1 and one as level 3 according to Brighton Collaboration. Most cases had the central nervous system (CNS) as the main site of thrombosis (21/39) and happened after the vaccine first dose (34/39). The median age of the cases was 41 years old (23 to 86 yo). Most of the cases (61.5%) occurred in women. The median interval between vaccination and onset of symptoms was 8 days (0-37 days). The platelet count and D-dimer count had median values of 34,000/µL and 19,235 µg FEU/L, respectively. The ELISA anti-PF4 antibody was positive in 18 samples. The overall mortality rate was 51% and was higher in cases of CNS thrombosis with intracerebral bleeding.Our case series shows that Brazilian VITT cases have similar clinical and laboratory profiles as demonstrated in the literature. Brazil has administered more than 300 million doses of COVID-19 vaccines (more than 110 million from ChAdOx1 nCoV-19). VITT seems to be a very rare but serious adverse event following COVID-19 immunization, especially adenoviral vector immunization.
Databáze: OpenAIRE
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