Thrombosis and Bleeding in Patients with Vaccine-Induced Immune Thrombotic Thrombocytopenia: A Systematic Review of Published Cases
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a highly prothrombotic reaction to COVID-19 (coronavirus disease 2019) adenoviral vector vaccines. Its distinct bleeding and thrombotic patterns compared with other platelet consumptive disorders remain unclear. We performed a systematic...
Uloženo v:
| Vydáno v: | Thrombosis and haemostasis Ročník 124; číslo 5; s. 423 |
|---|---|
| Hlavní autoři: | , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
Germany
01.05.2024
|
| Témata: | |
| ISSN: | 2567-689X, 2567-689X |
| On-line přístup: | Zjistit podrobnosti o přístupu |
| Tagy: |
Přidat tag
Žádné tagy, Buďte první, kdo vytvoří štítek k tomuto záznamu!
|
| Abstract | Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a highly prothrombotic reaction to COVID-19 (coronavirus disease 2019) adenoviral vector vaccines. Its distinct bleeding and thrombotic patterns compared with other platelet consumptive disorders remain unclear.
We performed a systematic review of the literature (PubMed and Embase) up to July 31, 2022, including case reports and case series providing nonaggregate data of VITT patients. Accurate VITT diagnosis required fulfillment of the following criteria: (1) endorsement by the authors, (2) consistent vaccine type and timing, (3) presence of thrombocytopenia and thrombosis, (4) detection of anti-platelet factor 4 antibodies. Data are presented as frequencies with 95% confidence intervals (CIs) calculated with the exact binomial method.
We retrieved 143 eligible studies, describing 366 patients. Of 647 thrombotic events, 53% (95% CI: 49-56) were venous thromboses at unusual sites and 30% (95% CI: 27-34) were cerebral venous sinus thromboses (CVSTs). The ratio of venous-to-arterial events was 4.1. Thromboses in most sites were associated with at least another thrombotic event, with the exception of CVST and CNS arterial thrombosis (isolated in 49 and 39% of cases, respectively). Bleeding occurred in 36% (95% CI: 31-41) of patients; 68% (95% CI: 59-75) of bleeding events were intracranial hemorrhages (ICHs). Overall mortality was 24% (95% CI: 19-29), and 77% (95% CI: 58-90) in patients with isolated CVST complicated by ICH.
VITT displays a venous-to-arterial thrombosis ratio comparable to heparin-induced thrombocytopenia. However, VITT is characterized by a higher prevalence of CVST and ICH, which contribute to the increased bleeding frequency and mortality. |
|---|---|
| AbstractList | Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a highly prothrombotic reaction to COVID-19 (coronavirus disease 2019) adenoviral vector vaccines. Its distinct bleeding and thrombotic patterns compared with other platelet consumptive disorders remain unclear.
We performed a systematic review of the literature (PubMed and Embase) up to July 31, 2022, including case reports and case series providing nonaggregate data of VITT patients. Accurate VITT diagnosis required fulfillment of the following criteria: (1) endorsement by the authors, (2) consistent vaccine type and timing, (3) presence of thrombocytopenia and thrombosis, (4) detection of anti-platelet factor 4 antibodies. Data are presented as frequencies with 95% confidence intervals (CIs) calculated with the exact binomial method.
We retrieved 143 eligible studies, describing 366 patients. Of 647 thrombotic events, 53% (95% CI: 49-56) were venous thromboses at unusual sites and 30% (95% CI: 27-34) were cerebral venous sinus thromboses (CVSTs). The ratio of venous-to-arterial events was 4.1. Thromboses in most sites were associated with at least another thrombotic event, with the exception of CVST and CNS arterial thrombosis (isolated in 49 and 39% of cases, respectively). Bleeding occurred in 36% (95% CI: 31-41) of patients; 68% (95% CI: 59-75) of bleeding events were intracranial hemorrhages (ICHs). Overall mortality was 24% (95% CI: 19-29), and 77% (95% CI: 58-90) in patients with isolated CVST complicated by ICH.
VITT displays a venous-to-arterial thrombosis ratio comparable to heparin-induced thrombocytopenia. However, VITT is characterized by a higher prevalence of CVST and ICH, which contribute to the increased bleeding frequency and mortality. Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a highly prothrombotic reaction to COVID-19 (coronavirus disease 2019) adenoviral vector vaccines. Its distinct bleeding and thrombotic patterns compared with other platelet consumptive disorders remain unclear.INTRODUCTION Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a highly prothrombotic reaction to COVID-19 (coronavirus disease 2019) adenoviral vector vaccines. Its distinct bleeding and thrombotic patterns compared with other platelet consumptive disorders remain unclear. We performed a systematic review of the literature (PubMed and Embase) up to July 31, 2022, including case reports and case series providing nonaggregate data of VITT patients. Accurate VITT diagnosis required fulfillment of the following criteria: (1) endorsement by the authors, (2) consistent vaccine type and timing, (3) presence of thrombocytopenia and thrombosis, (4) detection of anti-platelet factor 4 antibodies. Data are presented as frequencies with 95% confidence intervals (CIs) calculated with the exact binomial method.METHODS We performed a systematic review of the literature (PubMed and Embase) up to July 31, 2022, including case reports and case series providing nonaggregate data of VITT patients. Accurate VITT diagnosis required fulfillment of the following criteria: (1) endorsement by the authors, (2) consistent vaccine type and timing, (3) presence of thrombocytopenia and thrombosis, (4) detection of anti-platelet factor 4 antibodies. Data are presented as frequencies with 95% confidence intervals (CIs) calculated with the exact binomial method. We retrieved 143 eligible studies, describing 366 patients. Of 647 thrombotic events, 53% (95% CI: 49-56) were venous thromboses at unusual sites and 30% (95% CI: 27-34) were cerebral venous sinus thromboses (CVSTs). The ratio of venous-to-arterial events was 4.1. Thromboses in most sites were associated with at least another thrombotic event, with the exception of CVST and CNS arterial thrombosis (isolated in 49 and 39% of cases, respectively). Bleeding occurred in 36% (95% CI: 31-41) of patients; 68% (95% CI: 59-75) of bleeding events were intracranial hemorrhages (ICHs). Overall mortality was 24% (95% CI: 19-29), and 77% (95% CI: 58-90) in patients with isolated CVST complicated by ICH.RESULTS We retrieved 143 eligible studies, describing 366 patients. Of 647 thrombotic events, 53% (95% CI: 49-56) were venous thromboses at unusual sites and 30% (95% CI: 27-34) were cerebral venous sinus thromboses (CVSTs). The ratio of venous-to-arterial events was 4.1. Thromboses in most sites were associated with at least another thrombotic event, with the exception of CVST and CNS arterial thrombosis (isolated in 49 and 39% of cases, respectively). Bleeding occurred in 36% (95% CI: 31-41) of patients; 68% (95% CI: 59-75) of bleeding events were intracranial hemorrhages (ICHs). Overall mortality was 24% (95% CI: 19-29), and 77% (95% CI: 58-90) in patients with isolated CVST complicated by ICH. VITT displays a venous-to-arterial thrombosis ratio comparable to heparin-induced thrombocytopenia. However, VITT is characterized by a higher prevalence of CVST and ICH, which contribute to the increased bleeding frequency and mortality.CONCLUSION VITT displays a venous-to-arterial thrombosis ratio comparable to heparin-induced thrombocytopenia. However, VITT is characterized by a higher prevalence of CVST and ICH, which contribute to the increased bleeding frequency and mortality. |
| Author | Aloise, Chiara Perricone, Rosaria Birocchi, Simone Podda, Gian Marco Pontisso, Eleonora Pisetta, Chiara Clerici, Bianca Peroni, Benedetta Scavone, Mariangela |
| Author_xml | – sequence: 1 givenname: Bianca surname: Clerici fullname: Clerici, Bianca organization: Dipartimento di Scienze della Salute, Università degli Studi di Milano, Struttura Complessa di Medicina Generale II, Ospedale San Paolo, Milano, Italy – sequence: 2 givenname: Eleonora surname: Pontisso fullname: Pontisso, Eleonora organization: Dipartimento di Scienze della Salute, Università degli Studi di Milano, Struttura Complessa di Medicina Generale II, Ospedale San Paolo, Milano, Italy – sequence: 3 givenname: Chiara surname: Aloise fullname: Aloise, Chiara organization: Dipartimento di Scienze della Salute, Università degli Studi di Milano, Struttura Complessa di Medicina Generale II, Ospedale San Paolo, Milano, Italy – sequence: 4 givenname: Benedetta surname: Peroni fullname: Peroni, Benedetta organization: Dipartimento di Scienze della Salute, Università degli Studi di Milano, Struttura Complessa di Medicina Generale II, Ospedale San Paolo, Milano, Italy – sequence: 5 givenname: Rosaria surname: Perricone fullname: Perricone, Rosaria organization: Dipartimento di Scienze della Salute, Università degli Studi di Milano, Struttura Complessa di Medicina Generale II, Ospedale San Paolo, Milano, Italy – sequence: 6 givenname: Chiara surname: Pisetta fullname: Pisetta, Chiara organization: Dipartimento di Scienze della Salute, Università degli Studi di Milano, Struttura Complessa di Medicina Generale II, Ospedale San Paolo, Milano, Italy – sequence: 7 givenname: Mariangela surname: Scavone fullname: Scavone, Mariangela organization: Dipartimento di Scienze della Salute, Università degli Studi di Milano, Struttura Complessa di Medicina Generale II, Ospedale San Paolo, Milano, Italy – sequence: 8 givenname: Simone surname: Birocchi fullname: Birocchi, Simone organization: Dipartimento di Scienze della Salute, Università degli Studi di Milano, Struttura Complessa di Medicina Generale II, Ospedale San Paolo, Milano, Italy – sequence: 9 givenname: Gian Marco surname: Podda fullname: Podda, Gian Marco organization: Dipartimento di Scienze della Salute, Università degli Studi di Milano, Struttura Complessa di Medicina Generale II, Ospedale San Paolo, Milano, Italy |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38109906$$D View this record in MEDLINE/PubMed |
| BookMark | eNpNkMtLAzEYxINUtFavHiVHL6t57CveavFRKFi0irfl2-RbG9jN1k3W0rP_uBVb8DQD85s5zAkZuNYhIeecXXGWJNc-YiyWEc-yjMv4gAxFkmZRmqv3wT9_RI5lzplSLB2S78Wya5uy9dZTcIbe1ojGug9qHZ1DsOiCp2sblvQNtLYOo6kzvUZDp03TO6S7frB6b_UmtCt0Fm7omL5sfMAGfuNn_LK4pm1F531ZW7_cjkzAoz8lhxXUHs92OiKv93eLyWM0e3qYTsazSEspQ4QGUCFXuhRVxYEDCMmSWHGFGMdpYtIK0jJPOCoAzQUwmaeJULnKjc4qI0bk8m931bWfPfpQNNZrrGtw2Pa-EGrbSFTM5Ba92KF92aApVp1toNsU--PED5AmcQQ |
| CitedBy_id | crossref_primary_10_1080_21645515_2024_2363016 crossref_primary_10_1016_j_ajog_2024_04_028 crossref_primary_10_1016_j_ijid_2024_107095 crossref_primary_10_4081_btvb_2024_127 |
| ContentType | Journal Article |
| Copyright | Thieme. All rights reserved. |
| Copyright_xml | – notice: Thieme. All rights reserved. |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.1055/s-0043-1777134 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| EISSN | 2567-689X |
| ExternalDocumentID | 38109906 |
| Genre | Systematic Review Journal Article |
| GroupedDBID | CGR CUY CVF ECM EIF NPM 7X8 |
| ID | FETCH-LOGICAL-c333t-edae9e19cb2ff1a1aa23054919ee4465d6fa6b851e9aac12a0386529898dc7fd2 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 4 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=001126792000001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 2567-689X |
| IngestDate | Fri Jul 11 05:11:46 EDT 2025 Thu Apr 03 07:03:41 EDT 2025 |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 5 |
| Language | English |
| License | Thieme. All rights reserved. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c333t-edae9e19cb2ff1a1aa23054919ee4465d6fa6b851e9aac12a0386529898dc7fd2 |
| Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 |
| PMID | 38109906 |
| PQID | 2903859403 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2903859403 pubmed_primary_38109906 |
| PublicationCentury | 2000 |
| PublicationDate | 2024-05-01 |
| PublicationDateYYYYMMDD | 2024-05-01 |
| PublicationDate_xml | – month: 05 year: 2024 text: 2024-05-01 day: 01 |
| PublicationDecade | 2020 |
| PublicationPlace | Germany |
| PublicationPlace_xml | – name: Germany |
| PublicationTitle | Thrombosis and haemostasis |
| PublicationTitleAlternate | Thromb Haemost |
| PublicationYear | 2024 |
| Score | 2.4660554 |
| SecondaryResourceType | review_article |
| Snippet | Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a highly prothrombotic reaction to COVID-19 (coronavirus disease 2019) adenoviral vector vaccines.... |
| SourceID | proquest pubmed |
| SourceType | Aggregation Database Index Database |
| StartPage | 423 |
| SubjectTerms | Anticoagulants - adverse effects Case Reports as Topic COVID-19 - complications COVID-19 Vaccines - adverse effects Hemorrhage Humans Platelet Factor 4 - immunology Risk Factors SARS-CoV-2 - immunology Sinus Thrombosis, Intracranial - etiology Thrombosis - etiology Venous Thrombosis |
| Title | Thrombosis and Bleeding in Patients with Vaccine-Induced Immune Thrombotic Thrombocytopenia: A Systematic Review of Published Cases |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/38109906 https://www.proquest.com/docview/2903859403 |
| Volume | 124 |
| WOSCitedRecordID | wos001126792000001&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1JS8QwFA7qePDigtu4EcFrmLbptIkXGQdFDw4DjjK3kuUVC9qO01Hw7B83r4ueBMFL6SWlJC95y_fyfYSccaNjxblhnIfcJSihx4QJgPnGExacQUepqsQm4tFITKdy3BTcyqatsj0Tq4PaFgZr5L1AIoYlQ49fzF4ZqkYhutpIaCyTDnehDFp1PK1E6Ppu_0dCTluexn6_V7IKavbjGO9P_h5RVp7leuO__7RJ1puYkg5qI9giS5Bvk8_J07x40UWZlVTlll4-136KZjkd12SqJcUqLH1UBtF1hioeBiy9xSsjQJvx7pvtq_lYoNhWps7pgN5_U0DTGl-gRUrbJntLh847ljvk4fpqMrxhjeICM5zzBQOrQIIvjQ7S1Fe-Ui5DcRmkLwGQWc26lYu0C9JAKmX8QHkoGYok7sKaOLXBLlnJixz2CbU6jPtxgAEGhFpIpa3wLEQaIqGVEV1y2s5p4iwaYQqVQ_FWJj-z2iV79cIks5p6I0E-Muc_o4M_jD4ka4GLQOruxCPSSd1-hmOyat4XWTk_qUzFPUfjuy_8K8zc |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Thrombosis+and+Bleeding+in+Patients+with+Vaccine-Induced+Immune+Thrombotic+Thrombocytopenia%3A+A+Systematic+Review+of+Published+Cases&rft.jtitle=Thrombosis+and+haemostasis&rft.au=Clerici%2C+Bianca&rft.au=Pontisso%2C+Eleonora&rft.au=Aloise%2C+Chiara&rft.au=Peroni%2C+Benedetta&rft.date=2024-05-01&rft.eissn=2567-689X&rft.volume=124&rft.issue=5&rft.spage=423&rft_id=info:doi/10.1055%2Fs-0043-1777134&rft_id=info%3Apmid%2F38109906&rft_id=info%3Apmid%2F38109906&rft.externalDocID=38109906 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2567-689X&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2567-689X&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2567-689X&client=summon |