Cargando…
Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study
OBJECTIVES: Fatal complications have occurred after vaccination with ChAdOx1 nCoV-19, a vaccine against Covid-19. Vaccine-induced immune thrombotic thrombocytopenia (VITT) with severe outcome is characterized by venous thrombosis, predominantly in cerebral veins, thrombocytopenia and anti-PF4/polyan...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Author(s). Published by Elsevier Inc.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670733/ https://www.ncbi.nlm.nih.gov/pubmed/36403363 http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2022.106860 |
_version_ | 1784832396442468352 |
---|---|
author | Schultz, Nina Haagenrud Søraas, Arne Vasli Lund Sørvoll, Ingvild Hausberg Akkök, Çigdem Akalin Vetlesen, Annette Bhamra, Jagjit Singh Ahlen, Maria Therese Holme, Pål Andre Aamodt, Anne-Hege Skagen, Karolina Skattør, Thor Håkon Skjelland, Mona Wiedmann, Markus KH |
author_facet | Schultz, Nina Haagenrud Søraas, Arne Vasli Lund Sørvoll, Ingvild Hausberg Akkök, Çigdem Akalin Vetlesen, Annette Bhamra, Jagjit Singh Ahlen, Maria Therese Holme, Pål Andre Aamodt, Anne-Hege Skagen, Karolina Skattør, Thor Håkon Skjelland, Mona Wiedmann, Markus KH |
author_sort | Schultz, Nina Haagenrud |
collection | PubMed |
description | OBJECTIVES: Fatal complications have occurred after vaccination with ChAdOx1 nCoV-19, a vaccine against Covid-19. Vaccine-induced immune thrombotic thrombocytopenia (VITT) with severe outcome is characterized by venous thrombosis, predominantly in cerebral veins, thrombocytopenia and anti-PF4/polyanion antibodies. Prolonged headaches and cutaneous hemorrhages, frequently observed after the ChAdOx1 nCoV-19 vaccine, have therefore caused anxiety among vaccinees. We investigated whether these symptoms represent a mild form of VITT, with a potential for aggravation, e.g. in case of a second vaccination dose, or a different entity of vaccine complications MATERIALS AND METHODS: We included previously healthy individuals who had a combination of headache and spontaneous severe cutaneous hemorrhages emerging after the 1(st) dose of the ChAdOx1 nCoV-19 vaccine. Twelve individuals were found to meet the inclusion criteria, and a phone interview, cerebral MRI, assessment of platelet counts, anti PF4/polyanion antibodies and other laboratory tests were performed. RESULTS: None of the symptomatic vaccinees had cerebral vein thrombosis, hemorrhage or other pathology on MRI. Platelet counts were within normal range and no anti-PF4/polyanion platelet activating antibodies were found. Moreover, vasculitis markers, platelet activation markers and thrombin generation were normal. Furthermore, almost all symptoms resolved, and none had recurrence of symptoms after further vaccination with mRNA vaccines against Covid-19. CONCLUSIONS: The combination of headaches and subcutaneous hemorrhage did not represent VITT and no other specific coagulation disorder or intracranial pathology was found. However, symptoms initially mimicking VITT demand vigilance and low threshold for a clinical evaluation combined with platelet counts and D–dimer. |
format | Online Article Text |
id | pubmed-9670733 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | The Author(s). Published by Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-96707332022-11-17 Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study Schultz, Nina Haagenrud Søraas, Arne Vasli Lund Sørvoll, Ingvild Hausberg Akkök, Çigdem Akalin Vetlesen, Annette Bhamra, Jagjit Singh Ahlen, Maria Therese Holme, Pål Andre Aamodt, Anne-Hege Skagen, Karolina Skattør, Thor Håkon Skjelland, Mona Wiedmann, Markus KH J Stroke Cerebrovasc Dis Article OBJECTIVES: Fatal complications have occurred after vaccination with ChAdOx1 nCoV-19, a vaccine against Covid-19. Vaccine-induced immune thrombotic thrombocytopenia (VITT) with severe outcome is characterized by venous thrombosis, predominantly in cerebral veins, thrombocytopenia and anti-PF4/polyanion antibodies. Prolonged headaches and cutaneous hemorrhages, frequently observed after the ChAdOx1 nCoV-19 vaccine, have therefore caused anxiety among vaccinees. We investigated whether these symptoms represent a mild form of VITT, with a potential for aggravation, e.g. in case of a second vaccination dose, or a different entity of vaccine complications MATERIALS AND METHODS: We included previously healthy individuals who had a combination of headache and spontaneous severe cutaneous hemorrhages emerging after the 1(st) dose of the ChAdOx1 nCoV-19 vaccine. Twelve individuals were found to meet the inclusion criteria, and a phone interview, cerebral MRI, assessment of platelet counts, anti PF4/polyanion antibodies and other laboratory tests were performed. RESULTS: None of the symptomatic vaccinees had cerebral vein thrombosis, hemorrhage or other pathology on MRI. Platelet counts were within normal range and no anti-PF4/polyanion platelet activating antibodies were found. Moreover, vasculitis markers, platelet activation markers and thrombin generation were normal. Furthermore, almost all symptoms resolved, and none had recurrence of symptoms after further vaccination with mRNA vaccines against Covid-19. CONCLUSIONS: The combination of headaches and subcutaneous hemorrhage did not represent VITT and no other specific coagulation disorder or intracranial pathology was found. However, symptoms initially mimicking VITT demand vigilance and low threshold for a clinical evaluation combined with platelet counts and D–dimer. The Author(s). Published by Elsevier Inc. 2023-01 2022-11-17 /pmc/articles/PMC9670733/ /pubmed/36403363 http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2022.106860 Text en © 2022 The Author(s) Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Schultz, Nina Haagenrud Søraas, Arne Vasli Lund Sørvoll, Ingvild Hausberg Akkök, Çigdem Akalin Vetlesen, Annette Bhamra, Jagjit Singh Ahlen, Maria Therese Holme, Pål Andre Aamodt, Anne-Hege Skagen, Karolina Skattør, Thor Håkon Skjelland, Mona Wiedmann, Markus KH Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study |
title | Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study |
title_full | Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study |
title_fullStr | Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study |
title_full_unstemmed | Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study |
title_short | Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study |
title_sort | vaccine associated benign headache and cutaneous hemorrhage after chadox1 ncov-19 vaccine: a cohort study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9670733/ https://www.ncbi.nlm.nih.gov/pubmed/36403363 http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2022.106860 |
work_keys_str_mv | AT schultzninahaagenrud vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT søraasarnevaslilund vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT sørvollingvildhausberg vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT akkokcigdemakalin vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT vetlesenannette vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT bhamrajagjitsingh vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT ahlenmariatherese vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT holmepalandre vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT aamodtannehege vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT skagenkarolina vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT skattørthorhakon vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT skjellandmona vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy AT wiedmannmarkuskh vaccineassociatedbenignheadacheandcutaneoushemorrhageafterchadox1ncov19vaccineacohortstudy |