Review
Medical Laboratory Technology
Emmanuel J. Favaloro, Leonardo Pasalic, Giuseppe Lippi
Summary: COVID-19 vaccines may cause adverse events, and one rare event called vaccine-induced (immune) thrombotic thrombocytopenia (VITT) can have serious consequences. In response to increasing reports of VITT, expert groups have formulated guidelines for diagnosis and management.
CLINICAL CHEMISTRY AND LABORATORY MEDICINE
(2022)
Article
Immunology
Sisse R. Ostrowski, Ole S. Sogaard, Martin Tolstrup, Nina B. Staerke, Jens Lundgren, Lars Ostergaard, Anne-Mette Hvas
Summary: The introduction of COVID-19 vaccines has provided hope for controlling the pandemic, but some vaccines may be associated with serious thrombotic events. The pathogenesis of COVID-19 VITT is not fully understood, with research suggesting that AZ vaccine may induce more pronounced inflammation, platelet activation, and thrombin generation compared to mRNA vaccines.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Infectious Diseases
Elsa V. C. Rodriguez, Fatima-Zohra Bouazza, Nicolas Dauby, Francois Mullier, Stephanie d'Otreppe, Patrice Jissendi Tchofo, Magali Bartiaux, Camille Sirjacques, Alain Roman, Cedric Hermans, Manuel Cliquennois
Summary: This case report describes the first reported case of vaccine-induced immune thrombocytopenia (VITT) following Ad26.COV2.S vaccination outside the US. The importance of maintaining a high index of suspicion and early diagnosis and treatment in patients with symptoms compatible with VITT after receiving an adenovirus-vector-based SARS-CoV-2 vaccine is highlighted to improve prognosis and outcomes.
Review
Pathology
Emmanuel J. Favaloro, Leonardo Pasalic, Brandon Henry, Giuseppe Lippi
Summary: This article discusses laboratory testing for PF4 antibodies, particularly distinguishing patterns in HITT versus VITT.
Letter
Hematology
Guillaume Roberge, Marc Carrier
Summary: Vaccine-induced immune thrombotic thrombocytopenia (VITT) has been identified as a complication of adenovirus vector-based COVID-19 vaccines. It is associated with significant morbidity and mortality due to thrombosis-related complications. Diagnosis is confirmed through the detection of anti-PF4 antibodies using platelet factor 4 ELISA and platelet-activation assay. Although initial treatment strategy has been established, long-term management and follow-up remain uncertain.
THROMBOSIS RESEARCH
(2023)
Letter
Medicine, General & Internal
Theodore E. Warkentin, Jacquelyn Baskin-Miller, Alison L. Raybould, Jo-Ann I. Sheppard, Mercy Daka, Ishac Nazy, Stephan Moll
Summary: Thrombosis and thrombocytopenia can occur after adenovirus infection, possibly due to the action of antibodies targeting PF4.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Hematology
Jean M. Connors, Toshiaki Iba
Summary: The rapid development and implementation of COVID-19 vaccines has been a result of collaboration between the scientific community, government agencies, and pharmaceutical companies. However, the occurrence of vaccine-induced immune thrombotic thrombocytopenia syndrome (VITT) has prompted intense scientific efforts to understand this syndrome and develop effective therapies. Prompt communication and knowledge exchange among clinicians and scientists have been critical in advancing our understanding of VITT and reducing associated mortality.
THROMBOSIS RESEARCH
(2022)
Article
Immunology
Lisa Clarke, Timothy Brighton, Sanjeev D. Chunilal, Christine S. M. Lee, Freda Passam, Jennifer Curnow, Vivien M. Chen, Huyen A. Tran
Summary: This study describes the clinical and pathological features of VITT following dose 2 AZD1222 vaccination in Australia and compares it to cases of VITT after dose 1. The results show that although the clinical and pathological features of VITT after dose 2 are less severe, it still resulted in fatalities.
Article
Medicine, General & Internal
Caroline Dix, James McFadyen, Angela Huang, Sanjeev Chunilal, Vivien Chen, Huyen Tran
Summary: Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare but serious syndrome characterized by thrombocytopenia, thrombosis, elevated D-dimer, and the presence of anti-platelet factor-4 (PF4) antibodies after COVID-19 adenovirus vector vaccination. The pathogenesis of VITT is still under investigation, and thrombosis can occur in any vascular bed affecting multiple sites. Treatment includes anticoagulation, immunoglobulin, and plasma exchange.
INTERNAL MEDICINE JOURNAL
(2022)
Article
Immunology
Dennis McGonagle, Gabriele De Marco, Charles Bridgewood
Summary: The study explores the involvement of venous immunothrombotic mechanisms in SARS-CoV-2 infection and anti-SARS-CoV-2 DNA vaccination. It suggests that both SARS-CoV-2 infection and DNA vaccines may activate immune responses leading to autoimmunity and thrombosis, particularly in the venous system.
JOURNAL OF AUTOIMMUNITY
(2021)
Review
Medicine, Research & Experimental
Charles S. Abrams, Geoffrey D. Barnes
Summary: Billions of individuals worldwide have benefited from the large-scale rollout of COVID-19 vaccines. However, rare side effects such as SARS-CoV-2 vaccination-induced thrombotic thrombocytopenia (VITT) have been reported. This review discusses the incidence, pathophysiology, diagnosis, and treatment of VITT, which occurs in approximately 1/50,000 to 1/100,000 recipients of certain COVID-19 vaccines.
ANNUAL REVIEW OF MEDICINE
(2023)
Article
Hematology
Michelle Lavin, Patrick T. Elder, Denis O'Keeffe, Helen Enright, Eileen Ryan, Anna Kelly, Ezzat El Hassadi, Feargal P. McNicholl, Gary Benson, Giao N. Le, Mary Byrne, Kevin Ryan, Niamh M. O'Connell, James S. O'Donnell
Summary: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a newly identified condition associated with unusual thrombosis after AstraZeneca vaccination. Current guidelines may lack sensitivity to detect early cases of VITT, highlighting the need for increased clinical awareness and vigilance on presenting symptoms.
BRITISH JOURNAL OF HAEMATOLOGY
(2021)
Article
Hematology
Adam J. Kanack, Curtis G. Jones, Bandana Singh, Rachel R. Leger, Noah P. Splinter, Nahla M. Heikal, Rajiv K. Pruthi, Dong Chen, Gemlyn George, Mouhamed Y. Abou-Ismail, Geoffrey D. Wool, Krishna Gundabolu, Anand Padmanabhan
Summary: This study aimed to improve platelet storage conditions for functional testing and developed a simple assay endpoint by measuring the release of TSP1. The findings showed that cryopreserved platelets, with optimized storage conditions, can still be activated and used for detecting antibodies in HIT and VITT.
Article
Hematology
Adam J. Kanack, Bandana Singh, Gemlyn George, Krishna Gundabolu, Scott A. Koepsell, Mouhamed Yazan Abou-Ismail, Karen A. Moser, Kristi J. Smock, David Green, Ajay Major, Clarence W. Chan, Geoffrey D. Wool, Mark Reding, Aneel A. Ashrani, Antonios Bayas, Diane E. Grill, Anand Padmanabhan
Summary: Rare cases of VITT can occur in COVID-19 vaccinated individuals, with Ad26.COV2.S-induced VITT antibodies persisting for over 5 months and being specifically diagnosed using a novel PF4 ELISA test.
AMERICAN JOURNAL OF HEMATOLOGY
(2022)
Article
Immunology
Victor W. T. Ling, Bingwen Eugene Fan, Soon Lee Lau, Xiu Hue Lee, Chuen Wen Tan, Shir Ying Lee
Summary: This article reports a case of possible vaccine-induced immune thrombotic thrombocytopenia (VITT) after the Pfizer-BioNTech mRNA vaccine booster. The study discusses the diagnostic considerations in VITT and the challenges of performing confirmatory assays in non-specialized settings.