Volume : 08, Issue : 08, August – 2021

Title:

27.THROMBOCYTOPENIA AND ITS ASSOCIATED ISSUES INCLUDING ISCHEMIC STROKES, CLOTS AND BLEEDING REPORTS IN DIFFERENT COUNTRIES IN PATIENTS WHO NEWLY GET ADENOVIRAL VECTOR-BASED COVID-19 VACCINE

Authors :

Dr. Muhammad Arsalan Ali Sajid, Dr. Muhammad Hassan, Dr. Ismoilova Ziyoda Aktamovna, Dr. Sehar ul Hamad,Dr. Abdullah Faridi Zarin, Abdul Samee Ali, Yasir Iqbal

Abstract :

Here we are elaborating the cases of a rare reaction of COVID-19 vaccine based on adenoviral (ChAdOx1) vector, the reactions include thrombocytopenia (low level of platelets count), rare type of blood clots, and ischemic strokes. The cases describe first a Pakistani 55 years old man who was hypertensive and diagnosed MI before 3 years, was on different medication, took first shot of vaccine (AZD1222) and felt little weakness including headache, after 3rd day of shot a greater elevation in blood pressure was seen, later he fell unconscious and later on computer tomography scan on head showed clots in right hemisphere with acute cerebral edema, the patient was completely paralyzed on the left size, in the blood reports there was a rapid decline in platelets count from 110000 to 65000 per uL, patient had 2 cardiac strokes events on 7th day of hospitalization with 2nd cardiac stroke he passed away, with CT scan it showed clots in both hemisphere , and blood reports showed platelet factor (PE-4) reactive antibody, here we took a reference of Danish 60 years old woman who was diagnosed with same kind of events after receiving same vaccine first shot, she passed away on 6th day of hospitalization. Her CT scan and MRI scan also showed acute cerebral edema, and blood reports revealed platelet factor (PF-4) reactive antibody, many countries also reported such cases, but no detailed information was provided. This can be novel immune response against specific type of vaccine, need to be evaluated further.
Keywords: Thrombocytopenia, Hemorrhage, Stroke, antibodies, vector, vaccines

Cite This Article:

Please cite this article in press Muhammad Arsalan Ali Sajid et al., Thrombocytopenia And Its Associated Issues Including Ischemic Strokes, Clots And Bleeding Reports In Different Countries In Patients Who Newly Get Adenoviral Vector-Based Covid-19 Vaccine.., Indo Am. J. P. Sci, 2021; 08(08).

Number of Downloads : 10

References:

1. Blauenfeldt, R.A., Kristensen, S.R., Ernstsen, S.L., Kristensen, C.C.H., Simonsen, C.Z. and Hvas, A.M., 2021. Thrombocytopenia with acute ischemic stroke and bleeding in a patient newly vaccinated with an adenoviral vector‐based COVID‐19 vaccine. Journal of Thrombosis and Haemostasis.
2. Polack, F.P., Thomas, S.J., Kitchin, N., Absalon, J., Gurtman, A., Lockhart, S., Perez, J.L., Marc, G.P., Moreira, E.D., Zerbini, C. and Bailey, R., 2020. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine. New England Journal of Medicine.
3. Baden, L.R., El Sahly, H.M., Essink, B., Kotloff, K., Frey, S., Novak, R., Diemert, D., Spector, S.A., Rouphael, N., Creech, C.B. and McGettigan, J., 2021. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. New England Journal of Medicine, 384(5), pp.403-416.
4. Ramasamy, M.N., Minassian, A.M., Ewer, K.J., Flaxman, A.L., Folegatti, P.M., Owens, D.R., Voysey, M., Aley, P.K., Angus, B., Babbage, G. and Belij-Rammerstorfer, S., 2020. Safety and immunogenicity of ChAdOx1 nCoV-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): a single-blind, randomised, controlled, phase 2/3 trial. The Lancet, 396(10267), pp.1979-1993.
5. Voysey, M., Clemens, S.A.C., Madhi, S.A., Weckx, L.Y., Folegatti, P.M., Aley, P.K., Angus, B., Baillie, V.L., Barnabas, S.L., Bhorat, Q.E. and Bibi, S., 2021. Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK. The Lancet, 397(10269), pp.99-111.
6. Blauenfeldt, R.A., Kristensen, S.R., Ernstsen, S.L., Kristensen, C.C.H., Simonsen, C.Z. and Hvas, A.M., 2021. Thrombocytopenia with acute ischemic stroke and bleeding in a patient newly vaccinated with an adenoviral vector‐based COVID‐19 vaccine. Journal of Thrombosis and Haemostasis.
7. Blauenfeldt, R.A., Kristensen, S.R., Ernstsen, S.L., Kristensen, C.C.H., Simonsen, C.Z. and Hvas, A.M., 2021. Thrombocytopenia with acute ischemic stroke and bleeding in a patient newly vaccinated with an adenoviral vector‐based COVID‐19 vaccine. Journal of Thrombosis and Haemostasis.
8. Warkentin, T.E. and Sheppard, J.A.I., 2006. Testing for heparin-induced thrombocytopenia antibodies. Transfusion medicine reviews, 20(4), pp.259-272.
9. Greinacher, A., Selleng, K. and Warkentin, T.E., 2017. Autoimmune heparin‐induced thrombocytopenia. Journal of Thrombosis and Haemostasis, 15(11), pp.2099-2114.
10. Jaax, M.E. and Greinacher, A., 2012. Management of heparin-induced thrombocytopenia. Expert opinion on pharmacotherapy, 13(7), pp.987-1006.
11. Perdomo, J., Leung, H.H., Ahmadi, Z., Feng, Y., Passam, F.H. and Chong, B.H., 2018. Neutrophil Activation and Netosis Are the Key Drivers of Thrombosis in Heparin-Induced Thrombocytopenia. Blood, 132, p.378.
12. Daviet, F., Guervilly, C., Baldesi, O., Bernard-Guervilly, F., Pilarczyk, E., Genin, A., Lefebvre, L., Forel, J.M., Papazian, L. and Camoin-Jau, L., 2020. Heparin-induced thrombocytopenia in severe COVID-19. Circulation, 142(19), pp.1875-1877.
13. Greinacher, A., Thiele, T., Warkentin, T.E., Weisser, K., Kyrle, P.A. and Eichinger, S., 2021. Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. New England Journal of Medicine, 384(22), pp.2092-2101.
14. Schultz, N.H., Sørvoll, I.H., Michelsen, A.E., Munthe, L.A., Lund-Johansen, F., Ahlen, M.T., Wiedmann, M., Aamodt, A.H., Skattør, T.H., Tjønnfjord, G.E. and Holme, P.A., 2021. Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination. New England journal of medicine, 384(22), pp.2124-2130.
15. Muir, K.L., Kallam, A., Koepsell, S.A. and Gundabolu, K., 2021. Thrombotic thrombocytopenia after Ad26. COV2. S vaccination. New England Journal of Medicine, 384(20), pp.1964-1965.
16. Banna, M.H.A., Sayeed, A., Kundu, S., Christopher, E., Hasan, M.T., Begum, M.R., Kormoker, T., Dola, S.T.I., Hassan, M.M., Chowdhury, S. and Khan, M.S.I., 2020. The impact of the COVID-19 pandemic on the mental health of the adult population in Bangladesh: a nationwide cross-sectional study. International Journal of Environmental Health Research, pp.1-12.
17. Hunter, P.R., 2021. Thrombosis after covid-19 vaccination.
18. Douxfils, J., Favresse, J., Dogné, J.M., Lecompte, T., Susen, S., Cordonnier, C., Lebreton, A., Gosselin, R., Sié, P., Pernod, G. and Gruel, Y., 2021. Hypotheses behind the very rare cases of thrombosis with thrombocytopenia syndrome after SARS-CoV-2 vaccination. Thrombosis research, 203, pp.163-171.
19. Ledford, H., 2021. How could a COVID vaccine cause blood clots? Scientists race to investigate. Nature, 592(7854), pp.334-335.
20. Marcucci, R. and Marietta, M., 2021. Vaccine-induced thrombotic thrombocytopenia: the elusive link between thrombosis and adenovirus-based SARS-CoV-2 vaccines. Internal and Emergency Medicine, pp.1-7.
21. Lodigiani, C., Iapichino, G., Carenzo, L., Cecconi, M., Ferrazzi, P., Sebastian, T., Kucher, N., Studt, J.D., Sacco, C., Alexia, B. and Sandri, M.T., 2020. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thrombosis research, 191, pp.9-14