Vaccine-induced immune thrombotic thrombocytopenia after vaccination against Covid-19: A clinical dilemma for clinicians and patients

Zeinab Mohseni Afshar; Arefeh Babazadeh; Alireza Janbakhsh; Mandana Afsharian; Kiarash Saleki; Mohammad Barary; Soheil Ebrahimpour

doi:10.1002/rmv.2273

Vaccine-induced immune thrombotic thrombocytopenia after vaccination against Covid-19: A clinical dilemma for clinicians and patients

Rev Med Virol. 2022 Mar;32(2):e2273. doi: 10.1002/rmv.2273. Epub 2021 Jul 1.

Authors

Zeinab Mohseni Afshar¹, Arefeh Babazadeh², Alireza Janbakhsh¹, Mandana Afsharian¹, Kiarash Saleki^{3

4}, Mohammad Barary^{3

4}, Soheil Ebrahimpour²

Affiliations

¹ Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
² Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
³ Student Research Committee, Babol University of Medical Sciences, Babol, Iran.
⁴ USERN Office, Babol University of Medical Sciences, Babol, Iran.

Abstract

The coronavirus disease 2019 (Covid-19) pandemic has had devastating effects on public health worldwide, but the deployment of vaccines for Covid-19 protection has helped control the spread of SARS Coronavirus 2 (SARS-CoV-2) infection where they are available. The common side effects reported following Covid-19 vaccination were mostly self-restricted local reactions that resolved quickly. Nevertheless, rare vaccine-induced immune thrombotic thrombocytopenia (VITT) cases have been reported in some people being vaccinated against Covid-19. This review summarizes the thromboembolic events after Covid-19 vaccination and discusses its molecular mechanism, incidence rate, clinical manifestations and differential diagnosis. Then, a step-by-step algorithm for diagnosing such events, along with a management plan, are presented. In conclusion, considering the likeliness of acquiring severe SARS-CoV-2 infection and its subsequent morbidity and mortality, the benefits of vaccination outweigh its risks. Hence, if not already initiated, all governments should begin an effective and fast public vaccination plan to overcome this pandemic.

Keywords: CSVT; Covid-19; PVT; SARS-CoV-2; Thrombosis; VIPIT; VITT; Vaccination.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

COVID-19 Vaccines / adverse effects
COVID-19* / prevention & control
Humans
SARS-CoV-2
Thrombocytopenia* / diagnosis
Vaccination / adverse effects
Vaccines*

Substances

COVID-19 Vaccines
Vaccines