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SARS-CoV-2 vaccines are not associated with hypercoagulability in apparently healthy people

BACKGROUND: SARS-CoV-2 adenoviral vector DNA vaccines have been linked to the rare but serious thrombotic postvaccine complication vaccine-induced immune thrombotic thrombocytopenia. This has raised concerns regarding the possibility of increased thrombotic risk after any SARS-CoV-2 vaccines. OBJECT...

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Detalles Bibliográficos
Autores principales: Garabet, Lamya, Eriksson, Anna, Tjønnfjord, Eirik, Cui, Xue-Yan, Olsen, Magnus Kringstad, Jacobsen, Hege Karine, Jørgensen, Camilla Tøvik, Mathisen, Åse-Berit, Mowinckel, Marie-Christine, Ahlen, Maria Therese, Sørvoll, Ingvild Hausberg, Horvei, Kjersti Daae, Ernstsen, Siw Leiknes, Lægreid, Ingvild Jenssen, Stavik, Benedicte, Holst, René, Sandset, Per Morten, Ghanima, Waleed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9691277/
https://www.ncbi.nlm.nih.gov/pubmed/36448024
http://dx.doi.org/10.1016/j.rpth.2022.100002
Descripción
Sumario:BACKGROUND: SARS-CoV-2 adenoviral vector DNA vaccines have been linked to the rare but serious thrombotic postvaccine complication vaccine-induced immune thrombotic thrombocytopenia. This has raised concerns regarding the possibility of increased thrombotic risk after any SARS-CoV-2 vaccines. OBJECTIVES: To investigate whether SARS-CoV-2 vaccines cause coagulation activation leading to a hypercoagulable state. METHODS: This observational study included 567 health care personnel; 521 were recruited after the first dose of adenoviral vector ChAdOx1-S (Vaxzevria, AstraZeneca) vaccine and 46 were recruited prospectively before vaccination with a messenger RNA (mRNA) vaccine, either Spikevax (Moderna, n = 38) or Comirnaty (Pfizer-BioNTech, n = 8). In the mRNA group, samples were acquired before and 1 to 2 weeks after vaccination. In addition to the prevaccination samples, 56 unvaccinated blood donors were recruited as controls (total n = 102). Thrombin generation, D-dimer levels, and free tissue factor pathway inhibitor (TFPI) levels were analyzed. RESULTS: No participant experienced thrombosis, vaccine-induced immune thrombotic thrombocytopenia, or thrombocytopenia (platelet count <100 × 10(9)/L) 1 week to 1 month postvaccination. There was no increase in thrombin generation, D-dimer level, or TFPI level in the ChAdOx1-S vaccine group compared with controls or after the mRNA vaccines compared with baseline values. Eleven of 513 (2.1%) participants vaccinated with ChAdOx1-S had anti-PF4/polyanion antibodies without a concomitant increase in thrombin generation. CONCLUSION: In this study, SARS-CoV-2 vaccines were not associated with thrombosis, thrombocytopenia, increased thrombin generation, D-dimer levels, or TFPI levels compared with baseline or unvaccinated controls. These findings argue against the subclinical activation of coagulation post-COVID-19 vaccination.