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COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis

The current challenge worldwide is the administration of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. Even if rarely, severe vascular adverse reactions temporally related to vaccine administration have induced diffidence in the population at large. In particular, resea...

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Autores principales: Pomara, Cristoforo, Sessa, Francesco, Ciaccio, Marcello, Dieli, Francesco, Esposito, Massimiliano, Giammanco, Giovanni Maurizio, Garozzo, Sebastiano Fabio, Giarratano, Antonino, Prati, Daniele, Rappa, Francesca, Salerno, Monica, Tripodo, Claudio, Mannucci, Pier Mannuccio, Zamboni, Paolo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229116/
https://www.ncbi.nlm.nih.gov/pubmed/34073536
http://dx.doi.org/10.3390/diagnostics11060955
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author Pomara, Cristoforo
Sessa, Francesco
Ciaccio, Marcello
Dieli, Francesco
Esposito, Massimiliano
Giammanco, Giovanni Maurizio
Garozzo, Sebastiano Fabio
Giarratano, Antonino
Prati, Daniele
Rappa, Francesca
Salerno, Monica
Tripodo, Claudio
Mannucci, Pier Mannuccio
Zamboni, Paolo
author_facet Pomara, Cristoforo
Sessa, Francesco
Ciaccio, Marcello
Dieli, Francesco
Esposito, Massimiliano
Giammanco, Giovanni Maurizio
Garozzo, Sebastiano Fabio
Giarratano, Antonino
Prati, Daniele
Rappa, Francesca
Salerno, Monica
Tripodo, Claudio
Mannucci, Pier Mannuccio
Zamboni, Paolo
author_sort Pomara, Cristoforo
collection PubMed
description The current challenge worldwide is the administration of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. Even if rarely, severe vascular adverse reactions temporally related to vaccine administration have induced diffidence in the population at large. In particular, researchers worldwide are focusing on the so-called “thrombosis and thrombocytopenia after COVID-19 vaccination”. This study aims to establish a practical workflow to define the relationship between adverse events following immunization (AEFI) and COVID-19 vaccination, following the basic framework of the World Health Organization (WHO). Post-mortem investigation plays a pivotal role to support this causality relationship when death occurs. To demonstrate the usefulness and feasibility of the proposed workflow, we applied it to two exemplificative cases of suspected AEFI following COVID-19 vaccination. Based on the proposed model, we took into consideration any possible causality relationship between COVID-19 vaccine administration and AEFI. This led us to conclude that vaccination with ChAdOx1 nCov-19 may cause the rare development of immune thrombocytopenia mediated by platelet-activating antibodies against platelet factor 4 (PF4), which clinically mimics heparin-induced autoimmune thrombocytopenia. We suggest the adoption of the proposed methodology in order to confirm or rule out a causal relationship between vaccination and the occurrence of AEFI.
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spelling pubmed-82291162021-06-26 COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis Pomara, Cristoforo Sessa, Francesco Ciaccio, Marcello Dieli, Francesco Esposito, Massimiliano Giammanco, Giovanni Maurizio Garozzo, Sebastiano Fabio Giarratano, Antonino Prati, Daniele Rappa, Francesca Salerno, Monica Tripodo, Claudio Mannucci, Pier Mannuccio Zamboni, Paolo Diagnostics (Basel) Article The current challenge worldwide is the administration of anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines. Even if rarely, severe vascular adverse reactions temporally related to vaccine administration have induced diffidence in the population at large. In particular, researchers worldwide are focusing on the so-called “thrombosis and thrombocytopenia after COVID-19 vaccination”. This study aims to establish a practical workflow to define the relationship between adverse events following immunization (AEFI) and COVID-19 vaccination, following the basic framework of the World Health Organization (WHO). Post-mortem investigation plays a pivotal role to support this causality relationship when death occurs. To demonstrate the usefulness and feasibility of the proposed workflow, we applied it to two exemplificative cases of suspected AEFI following COVID-19 vaccination. Based on the proposed model, we took into consideration any possible causality relationship between COVID-19 vaccine administration and AEFI. This led us to conclude that vaccination with ChAdOx1 nCov-19 may cause the rare development of immune thrombocytopenia mediated by platelet-activating antibodies against platelet factor 4 (PF4), which clinically mimics heparin-induced autoimmune thrombocytopenia. We suggest the adoption of the proposed methodology in order to confirm or rule out a causal relationship between vaccination and the occurrence of AEFI. MDPI 2021-05-26 /pmc/articles/PMC8229116/ /pubmed/34073536 http://dx.doi.org/10.3390/diagnostics11060955 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pomara, Cristoforo
Sessa, Francesco
Ciaccio, Marcello
Dieli, Francesco
Esposito, Massimiliano
Giammanco, Giovanni Maurizio
Garozzo, Sebastiano Fabio
Giarratano, Antonino
Prati, Daniele
Rappa, Francesca
Salerno, Monica
Tripodo, Claudio
Mannucci, Pier Mannuccio
Zamboni, Paolo
COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis
title COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis
title_full COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis
title_fullStr COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis
title_full_unstemmed COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis
title_short COVID-19 Vaccine and Death: Causality Algorithm According to the WHO Eligibility Diagnosis
title_sort covid-19 vaccine and death: causality algorithm according to the who eligibility diagnosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8229116/
https://www.ncbi.nlm.nih.gov/pubmed/34073536
http://dx.doi.org/10.3390/diagnostics11060955
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