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Síndrome de trombosis con trombocitopenia asociado a vacunas de adenovirus frente a la COVID-19: Epidemiología y presentación clínica de la serie española()

BACKGROUND: We describe the epidemiological and clinical characteristics of thrombosis with thrombocytopenia syndrome (TTS) cases reported in Spain. METHODS: We included all venous or arterial thrombosis with thrombocytopenia following adenovirus vector-based vaccines (AstraZeneca or Janssen) to pre...

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Detalles Bibliográficos
Autores principales: García-Azorín, D., Lázaro, E., Ezpeleta, D., Lecumberri, R., de la Cámara, R., Castellanos, M., Iñiguez Martínez, C., Quiroga-González, L., Elizondo Rivas, G., Sancho-López, A., Rayón Iglesias, P., Segovia, E., Mejías, C., Montero Corominas, D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedad Española de Neurología. Published by Elsevier España, S.L.U. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9124923/
https://www.ncbi.nlm.nih.gov/pubmed/35645442
http://dx.doi.org/10.1016/j.nrl.2022.04.010
Descripción
Sumario:BACKGROUND: We describe the epidemiological and clinical characteristics of thrombosis with thrombocytopenia syndrome (TTS) cases reported in Spain. METHODS: We included all venous or arterial thrombosis with thrombocytopenia following adenovirus vector-based vaccines (AstraZeneca or Janssen) to prevent COVID-19 disease between February 1(st) and September 26(th), 2021. We describe the crude rate and the standardized morbidity ratio. We assessed the predictors of mortality. RESULTS: Sixty-one cases were reported and 45 fulfilled eligibility criteria, 82% women. The crude TTS rate was 4/1,000,000 doses and 14-15/1,000,000 doses between 30-49 years. The number of observed cases of cerebral venous thrombosis was 6-18 higher than the expected in patients younger than 49 years. Symptoms started 10 (interquartile range [IQR]: 7-14) days after vaccination. Eighty percent (95% confidence interval [CI]: 65-90%) had thrombocytopenia at the time of the emergency department visit, and 65% (95% CI: 49-78%) had D-dimer >2,000 ng/mL. Patients had multiple location thrombosis in 36% and fatal outcome in 24% cases. A platelet nadir < 50,000/μL (odds ratio [OR]: 7.4; CI 95%: 1.2-47.5) and intracranial hemorrhage (OR: 7.9; IC 95%: 1.3-47.0) were associated with fatal outcome. CONCLUSION: TTS must be suspected in patients with symptoms 10 days after vaccination and thrombocytopenia and/or D-dimer increase.