Only Subclinical Alterations in the Haemostatic System of People with Diabetes after COVID-19 Vaccination

Viruses. 2022 Dec 20;15(1):10. doi: 10.3390/v15010010.


People with diabetes have an increased risk of experiencing adverse COVID-19 outcomes. COVID-19 vaccination is, therefore, highly recommended. However, people with diabetes have an inherently elevated risk of thrombotic events and the impact of the vaccination on the coagulation system in this patient population remains to be elucidated. The aim of this study was to investigate the impact of COVID-19 vaccination on the haemostatic system in people with type 1 or type 2 diabetes. We evaluated the effects of COVID-19 vaccination (BioNTech Pfizer, Moderna, AstraZeneca) on standard coagulation parameters, whole blood coagulation (Thrombelastometry), platelet function (impedance aggregation), and thrombin generation (calibrated automated thrombography) in people with type 1 diabetes mellitus (n = 41) and type 2 diabetes mellitus (n = 37). Blood sampling points were prior to vaccination and two weeks after the respective vaccination. Thrombelastometry measurements indicated moderately increased clot formation post-vaccination in people with type 1, as well as with type 2, diabetes: "Clot formation times" were significantly shorter, and both "maximum clot firmness" and "alpha angles" were significantly higher, as compared to the respective pre-vaccination values. Therefore, TEM parameters were not altered after vaccination in patients receiving ASA. Moreover, platelet aggregation was enhanced in people with type 1 diabetes, and plasma levels of D-Dimer were increased in people with type 2 diabetes, following COVID-19 vaccination. All other standard coagulation parameters, as well as thrombin generation, were not affected by the vaccination. The coagulation responses of people with diabetes to COVID-19 vaccination were only subclinical and comparable to those observed in healthy individuals. Our findings suggest that people with diabetes do not face an increased activation of the coagulation post-vaccination.

Keywords: COVID-19; platelet function; thrombelastometry; thrombin generation; type 1 diabetes; type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • COVID-19 Vaccines / adverse effects
  • COVID-19* / prevention & control
  • Diabetes Mellitus, Type 1*
  • Diabetes Mellitus, Type 2*
  • Hemostatics*
  • Humans
  • Thrombin
  • Vaccination


  • COVID-19 Vaccines
  • Thrombin
  • Hemostatics

Grants and funding

B.D.G. thanks Fundación Martínez Escudero for a postdoctoral grant. H.S. was supported by Austrian Science Fund (FWF) KLI-1076.