COVID-19 Vaccine-Induced Thrombotic Thrombocytopenia Leading to Stroke: An Extremely Rare but Possible Condition
Keywords:
Coronavirus Disease 2019, Vaccine-Induced Thrombotic Thrombocytopenia, Stroke, COVID-19 Vaccines, Adenovirus Vector-Based VaccineAbstract
Coronavirus disease 2019 (COVID-19) vaccines remain the safest and most effective strategy against the COVID-19 pandemic. However, clinicians must be aware of any adverse events that might arise as a peculiar side effect in certain individuals. One of such extremely rare side effect that needs to be routinely integrated into the clinical decision-making arise from vector based COVID-19 vaccines that result in vaccine-induced thrombotic thrombocytopenia (VITT) and consequently stroke. Understanding any evolving information that relates with COVID-19 is critical to its successful containment and control. As such, unraveling the mechanism of VITT leading to stroke as well as its relevant clinical information is essential towards its successful integration into clinical guidelines. This short communication was therefore aimed at focusing on proposed mechanism through which stroke evolved from vaccine-induced thrombotic thrombocytopenia and its relevant clinical information for clinical practice. This study stresses the importance of being vigilant to the development of vaccine-induced thrombotic thrombocytopenia and stroke especially from the viewpoint of clinicians and other health care personnel. The phenomenon of VITT leading to stroke was also recommended for inclusion as a standard operation procedure in the standard clinical guidelines for the management of acute ischemic stroke.
References
Kakovan M, Shirkouhi SG, Zarei M, Andalib S. Stroke associated with COVID-19 vaccines. J Stroke Cerebrovasc Dis. 2022:106440.
Toh C-H, Wang G, Parker AL. The aetiopathogenesis of vaccine-induced immune thrombotic thrombocytopenia. Clin Med (Northfield Il). 2022;22(2):140.
Muhammad M, Hassan TM, Baba SS, Radda MI, Mutawakkil MM, Musa MA, et al. Exploring NFκB pathway as a potent strategy to mitigate COVID-19 severe morbidity and mortality. Journal of Public Health in Africa. 2022;13(3).
Muhammad M, Ibrahim SA, Yarube IU, Bello B. A review on emerging pathogenesis of COVID-19 and points of concern for research communities in Nigeria. African Journal of Infectious Diseases. 2021;15(2):36-43.
Furie KL, Cushman M, Elkind MS, Lyden PD, Saposnik G, Leadership AHAASASC. Diagnosis and management of cerebral venous sinus thrombosis with vaccine-induced immune thrombotic thrombocytopenia. Stroke. 2021;52(7):2478-82.
Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger S. Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. N Engl J Med. 2021;384(22):2092-101.
Schultz NH, Sørvoll IH, Michelsen AE, Munthe LA, Lund-Johansen F, Ahlen MT, et al. Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021;384(22):2124-30.
Pai M, Chan B, Stall N, Grill A, Ivers N, Maltsev A, et al. Vaccine-induced immune thrombotic thrombocytopenia (VITT) following adenovirus vector COVID-19 vaccination. Science Briefs of the Ontario COVID-19 Science Advisory Table. 2021;2(17):1-7.
Hunter PR. Thrombosis after COVID-19 vaccination. British Medical Journal Publishing Group; 2021.
McGonagle D, De Marco G, Bridgewood C. Mechanisms of immunothrombosis in vaccine-induced thrombotic thrombocytopenia (VITT) compared to natural SARS-CoV-2 infection. J Autoimmun. 2021;121:102662.
Blauenfeldt RA, Kristensen SR, Ernstsen SL, Kristensen CCH, Simonsen CZ, Hvas AM. Thrombocytopenia with acute ischemic stroke and bleeding in a patient newly vaccinated with an adenoviral vector-based COVID-19 vaccine. J Thromb Haemost. 2021;19(7):1771-5.
Scully M, Singh D, Lown R, Poles A, Solomon T, Levi M, et al. Pathologic antibodies to platelet factor 4 after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021;384(23):2202-11.
Bayas A, Menacher M, Christ M, Behrens L, Rank A, Naumann M. Bilateral superior ophthalmic vein thrombosis, ischaemic stroke, and immune thrombocytopenia after ChAdOx1 nCoV-19 vaccination. The Lancet. 2021;397(10285):e11.
Rahmig J, Altarsha E, Siepmann T, Barlinn K. Acute ischemic stroke in the context of SARS-CoV-2 vaccination: a systematic review. Neuropsychiatr Dis Treat. 2022:1907-16.
Cascio Rizzo A, Giussani G, Agostoni EC. Ischemic stroke and vaccine-induced immune thrombotic thrombocytopenia following COVID-19 vaccine: a case report with systematic review of the literature. Cerebrovasc Dis. 2022;51(6):722-34.
Muir K-L, Kallam A, Koepsell SA, Gundabolu K. Thrombotic thrombocytopenia after Ad26. COV2. S vaccination. N Engl J Med. 2021;384(20):1964-5.
Cines DB, Bussel JB. SARS-CoV-2 vaccine–induced immune thrombotic thrombocytopenia. Mass Medical Soc; 2021. p. 2254-6.
Barnes GD, Cuker A, Piazza G, Siegal D. Vaccine-induced thrombotic thrombocytopenia (VITT) and COVID-19 vaccines: what cardiovascular clinicians need to know. Am Coll Cardiol. 2021.
Warkentin TE, Cuker A. COVID-19: Vaccine-induced immune thrombotic thrombocytopenia (VITT). Update May. 2021;7.
Kolahchi Z, Khanmirzaei M, Mowla A. Acute ischemic stroke and vaccine-induced immune thrombotic thrombocytopenia post COVID-19 vaccination; a systematic review. J Neurol Sci. 2022:120327.
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