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

Authors
 Jimin Hwang  ;  Young Joo Han  ;  Dong Keon Yon  ;  Seung Won Lee  ;  Beom Kyung Kim  ;  Se Bee Lee  ;  Min Ho Lee  ;  Seung Hyun Park  ;  Ai Koyanagi  ;  Louis Jacob  ;  Kalthoum Tizaoui  ;  Seung Up Kim  ;  Jae Il Shin  ;  Lee Smith 
Citation
 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES, Vol.116 : 114-121, 2022-03 
Journal Title
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
ISSN
 1201-9712 
Issue Date
2022-03
MeSH
COVID-19 Vaccines / adverse effects ; COVID-19* ; ChAdOx1 nCoV-19 ; Humans ; SARS-CoV-2 ; Thrombocytopenia* / etiology ; Thrombosis* ; Vaccination / adverse effects ; Vaccines*
Keywords
COVID-19 vaccine ; ChAdOx1 nCoV-19 ; Vaccine-induced immune thrombotic thrombocytopenia ; hepatosplenic thrombosis ; vaccine, portal vein thrombosis
Abstract
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.
Files in This Item:
T202200629.pdf Download
DOI
10.1016/j.ijid.2021.12.352
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188097
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