| Author | Oliveira, Patricia Mouta Nunes de | |
| Author | Porto, Victor Bertollo Gomes | |
| Author | Cordeiro, Catherine Crespo | |
| Author | Teixeira, Gabriellen Vitiello | |
| Author | Pedro, Renata Saraiva | |
| Author | Takey, Paulo Roberto Gomes | |
| Author | Lignani, Letícia Kegele | |
| Author | Xavier, Janaína Reis | |
| Author | Gama, Vitor Cardoso Doria da | |
| Author | Filho, Luiz Amorim | |
| Author | Furtado, Bárbara Emoingt | |
| Author | Maria, André Santa | |
| Author | Barros, Tiago Dahrug | |
| Author | Freitas, Livia Neves Waite | |
| Author | Pereira, Tainá Dos Santos | |
| Author | Abreu, Debora Lima | |
| Author | Ramos, Michael Bernardes | |
| Author | Gabe, Caroline | |
| Author | Arnold, Donald | |
| Author | Smith, James William | |
| Author | Nazy, Ishac | |
| Author | Maia, Maria de Lourdes de Sousa | |
| Author | Mendes-de-Almeida, Daniela P. | |
| Access date | 2024-03-07T14:06:49Z | |
| Available date | 2024-03-07T14:06:49Z | |
| Document date | 2022 | |
| Citation | OLIVEIRA, Patricia Mouta Nunes de et al. Vaccine-induced immune thrombotic thrombocytopenia after COVID-19 vaccination: Description of a series of 39 cases in Brazil. Vaccine, v. 40, n. 33, p. 4788-4795, 2022. | en_US |
| ISSN | 0264-410X | en_US |
| URI | https://www.arca.fiocruz.br/handle/icict/62961 | |
| Language | eng | en_US |
| Publisher | Elsevier | en_US |
| Rights | open access | en_US |
| Title | Vaccine-induced immune thrombotic thrombocytopenia after COVID-19 vaccination: Description of a series of 39 cases in Brazil | en_US |
| Type | Article | en_US |
| DOI | 10.1016/j.vaccine.2022.06.014 | |
| Abstract | COVID-19 vaccination in Brazil that included ChAdOx1 nCoV-19, Ad26.COV2.S and BNT162b2 vaccines, describing their clinical and laboratory characteristics. Methodology: 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. Results: 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/lL and 19,235 lg 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 mwith intracerebral bleeding. Conclusion: 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. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Ministério da Saúde. Programa Nacional de Imunizações. Coordenação Geral do Programa Nacional de Imunizações. Brasília, DF, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Hemorio. Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | AstraZeneca Brasil. Brasília, DF, Brasil. | en_US |
| Affilliation | AstraZeneca Brasil. Brasília, DF, Brasil. | en_US |
| Affilliation | Ministério da Saúde. Programa Nacional de Imunizações. Coordenação Geral do Programa Nacional de Imunizações. Brasília, DF, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Universidade de São Paulo. Faculdade de Medicina. Programa de Doutorado em Medicina. São Paulo, SP, Brasil. | en_US |
| Affilliation | McMaster Platelet Immunology Laboratory, Canada. | en_US |
| Affilliation | McMaster Platelet Immunology Laboratory, Canada. | en_US |
| Affilliation | McMaster Platelet Immunology Laboratory, Canada. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Rio de Janeiro, RJ, Brasil. | en_US |
| Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Departamento de Hematologia. Rio de Janeiro, RJ, Brasil / Instituto Nacional de Câncer. Centro de Pesquisa. Divisão de Carcinogênese Molecular. Rio de Janeiro, RJ, Brasil / University of Minnesota. Department of Pediatrics. Division of Epidemiology. Minneapolis, United States of America. | en_US |
| Subject | Thrombosis | en_US |
| Subject | Thrombocytopenia | en_US |
| Subject | COVID-19 | en_US |
| Subject | Vaccine-induced immune thrombotic | en_US |
| Subject | thrombocytopenia | en_US |
| xmlui.metadata.dc.subject.ods | 03 Saúde e Bem-Estar | |
