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COVID-19 Disease, Women’s Predominant Non-Heparin Vaccine-Induced Thrombotic Thrombocytopenia and Kounis Syndrome: A Passepartout Cytokine Storm Interplay

Coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitute one of the deadliest pandemics in modern history demonstrating cardiovascular, gastrointestinal, hematologic, mucocutaneous, respiratory, neurological, renal and testicular manifestations...

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Autores principales: Kounis, Nicholas G., Koniari, Ioanna, de Gregorio, Cesare, Assimakopoulos, Stelios F., Velissaris, Dimitrios, Hung, Ming-Yow, Mplani, Virginia, Saba, Luca, Brinia, Aikaterini, Kouni, Sophia N., Gogos, Christos, Giovannini, Mattia, Novembre, Elio, Arumugham, Vinu, Ricke, Darrell O., Soufras, George D., Nugent, Kenneth, Sestili, Piero, Malone, Robert W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8391920/
https://www.ncbi.nlm.nih.gov/pubmed/34440163
http://dx.doi.org/10.3390/biomedicines9080959
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author Kounis, Nicholas G.
Koniari, Ioanna
de Gregorio, Cesare
Assimakopoulos, Stelios F.
Velissaris, Dimitrios
Hung, Ming-Yow
Mplani, Virginia
Saba, Luca
Brinia, Aikaterini
Kouni, Sophia N.
Gogos, Christos
Giovannini, Mattia
Novembre, Elio
Arumugham, Vinu
Ricke, Darrell O.
Soufras, George D.
Nugent, Kenneth
Sestili, Piero
Malone, Robert W.
author_facet Kounis, Nicholas G.
Koniari, Ioanna
de Gregorio, Cesare
Assimakopoulos, Stelios F.
Velissaris, Dimitrios
Hung, Ming-Yow
Mplani, Virginia
Saba, Luca
Brinia, Aikaterini
Kouni, Sophia N.
Gogos, Christos
Giovannini, Mattia
Novembre, Elio
Arumugham, Vinu
Ricke, Darrell O.
Soufras, George D.
Nugent, Kenneth
Sestili, Piero
Malone, Robert W.
author_sort Kounis, Nicholas G.
collection PubMed
description Coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitute one of the deadliest pandemics in modern history demonstrating cardiovascular, gastrointestinal, hematologic, mucocutaneous, respiratory, neurological, renal and testicular manifestations and further complications. COVID-19-induced excessive immune response accompanied with uncontrolled release of cytokines culminating in cytokine storm seem to be the common pathogenetic mechanism of these complications. The aim of this narrative review is to elucidate the relation between anaphylaxis associated with profound hypotension or hypoxemia with pro-inflammatory cytokine release. COVID-19 relation with Kounis syndrome and post-COVID-19 vaccination correlation with heparin-induced thrombocytopenia with thrombosis (HITT), especially serious cerebral venous sinus thrombosis, were also reviewed. Methods: A current literature search in PubMed, Embase and Google databases was performed to reveal the pathophysiology, prevalence, clinical manifestation, correlation and treatment of COVID-19, anaphylaxis with profuse hypotension, Kounis acute coronary syndrome and thrombotic events post vaccination. Results: The same key immunological pathophysiology mechanisms and cells seem to underlie COVID-19 cardiovascular complications and the anaphylaxis-associated Kounis syndrome. The myocardial injury in patients with COVID-19 has been attributed to coronary spasm, plaque rupture and microthrombi formation, hypoxic injury or cytokine storm disposing the same pathophysiology with the three clinical variants of Kounis syndrome. COVID-19-interrelated vaccine excipients as polysorbate, polyethelene glycol (PEG) and trometamol constitute potential allergenic substances. Conclusion: Better acknowledgement of the pathophysiological mechanisms, clinical similarities, multiorgan complications of COVID-19 or other viral infections as dengue and human immunodeficiency viruses along with the action of inflammatory cells inducing the Kounis syndrome could identify better immunological approaches for prevention, treatment of the COVID-19 pandemic as well as post-COVID-19 vaccine adverse reactions.
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spelling pubmed-83919202021-08-28 COVID-19 Disease, Women’s Predominant Non-Heparin Vaccine-Induced Thrombotic Thrombocytopenia and Kounis Syndrome: A Passepartout Cytokine Storm Interplay Kounis, Nicholas G. Koniari, Ioanna de Gregorio, Cesare Assimakopoulos, Stelios F. Velissaris, Dimitrios Hung, Ming-Yow Mplani, Virginia Saba, Luca Brinia, Aikaterini Kouni, Sophia N. Gogos, Christos Giovannini, Mattia Novembre, Elio Arumugham, Vinu Ricke, Darrell O. Soufras, George D. Nugent, Kenneth Sestili, Piero Malone, Robert W. Biomedicines Review Coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitute one of the deadliest pandemics in modern history demonstrating cardiovascular, gastrointestinal, hematologic, mucocutaneous, respiratory, neurological, renal and testicular manifestations and further complications. COVID-19-induced excessive immune response accompanied with uncontrolled release of cytokines culminating in cytokine storm seem to be the common pathogenetic mechanism of these complications. The aim of this narrative review is to elucidate the relation between anaphylaxis associated with profound hypotension or hypoxemia with pro-inflammatory cytokine release. COVID-19 relation with Kounis syndrome and post-COVID-19 vaccination correlation with heparin-induced thrombocytopenia with thrombosis (HITT), especially serious cerebral venous sinus thrombosis, were also reviewed. Methods: A current literature search in PubMed, Embase and Google databases was performed to reveal the pathophysiology, prevalence, clinical manifestation, correlation and treatment of COVID-19, anaphylaxis with profuse hypotension, Kounis acute coronary syndrome and thrombotic events post vaccination. Results: The same key immunological pathophysiology mechanisms and cells seem to underlie COVID-19 cardiovascular complications and the anaphylaxis-associated Kounis syndrome. The myocardial injury in patients with COVID-19 has been attributed to coronary spasm, plaque rupture and microthrombi formation, hypoxic injury or cytokine storm disposing the same pathophysiology with the three clinical variants of Kounis syndrome. COVID-19-interrelated vaccine excipients as polysorbate, polyethelene glycol (PEG) and trometamol constitute potential allergenic substances. Conclusion: Better acknowledgement of the pathophysiological mechanisms, clinical similarities, multiorgan complications of COVID-19 or other viral infections as dengue and human immunodeficiency viruses along with the action of inflammatory cells inducing the Kounis syndrome could identify better immunological approaches for prevention, treatment of the COVID-19 pandemic as well as post-COVID-19 vaccine adverse reactions. MDPI 2021-08-05 /pmc/articles/PMC8391920/ /pubmed/34440163 http://dx.doi.org/10.3390/biomedicines9080959 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 Review
Kounis, Nicholas G.
Koniari, Ioanna
de Gregorio, Cesare
Assimakopoulos, Stelios F.
Velissaris, Dimitrios
Hung, Ming-Yow
Mplani, Virginia
Saba, Luca
Brinia, Aikaterini
Kouni, Sophia N.
Gogos, Christos
Giovannini, Mattia
Novembre, Elio
Arumugham, Vinu
Ricke, Darrell O.
Soufras, George D.
Nugent, Kenneth
Sestili, Piero
Malone, Robert W.
COVID-19 Disease, Women’s Predominant Non-Heparin Vaccine-Induced Thrombotic Thrombocytopenia and Kounis Syndrome: A Passepartout Cytokine Storm Interplay
title COVID-19 Disease, Women’s Predominant Non-Heparin Vaccine-Induced Thrombotic Thrombocytopenia and Kounis Syndrome: A Passepartout Cytokine Storm Interplay
title_full COVID-19 Disease, Women’s Predominant Non-Heparin Vaccine-Induced Thrombotic Thrombocytopenia and Kounis Syndrome: A Passepartout Cytokine Storm Interplay
title_fullStr COVID-19 Disease, Women’s Predominant Non-Heparin Vaccine-Induced Thrombotic Thrombocytopenia and Kounis Syndrome: A Passepartout Cytokine Storm Interplay
title_full_unstemmed COVID-19 Disease, Women’s Predominant Non-Heparin Vaccine-Induced Thrombotic Thrombocytopenia and Kounis Syndrome: A Passepartout Cytokine Storm Interplay
title_short COVID-19 Disease, Women’s Predominant Non-Heparin Vaccine-Induced Thrombotic Thrombocytopenia and Kounis Syndrome: A Passepartout Cytokine Storm Interplay
title_sort covid-19 disease, women’s predominant non-heparin vaccine-induced thrombotic thrombocytopenia and kounis syndrome: a passepartout cytokine storm interplay
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8391920/
https://www.ncbi.nlm.nih.gov/pubmed/34440163
http://dx.doi.org/10.3390/biomedicines9080959
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