COVID-19 Adenoviral Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT), COVID-19-Related Thrombosis, and the Thrombotic Thrombocytopenic Syndromes
Adenoviral-based vaccines such as ChadoX1 CoV-19 (AstraZeneca) and Ad26.COV2.S (J&J) were developed to prevent infection and reduce hospitalization or death in Coronavirus Disease 2019 (COVID-19) patients. Although these vaccines passed safety and efficacy trials with excellent neutralizing capa...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-12-01
|
| Series: | Hematology Reports |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2038-8330/14/4/50 |
| _version_ | 1797457421071810560 |
|---|---|
| author | Gewil Daniella Olipas Allas Joekeem Del Rosario Arizala Rafael Vincent Mercado Manalo |
| author_facet | Gewil Daniella Olipas Allas Joekeem Del Rosario Arizala Rafael Vincent Mercado Manalo |
| author_sort | Gewil Daniella Olipas Allas |
| collection | DOAJ |
| description | Adenoviral-based vaccines such as ChadoX1 CoV-19 (AstraZeneca) and Ad26.COV2.S (J&J) were developed to prevent infection and reduce hospitalization or death in Coronavirus Disease 2019 (COVID-19) patients. Although these vaccines passed safety and efficacy trials with excellent neutralizing capabilities against SARS-CoV-2, very rare reports of acute thrombotic thrombocytopenic events following administration emerged in certain populations, which triggered a series of clinical investigations that gave rise to a novel phenomenon called vaccine-induced immune thrombotic thrombocytopenia (VITT). Several converging pathways exist between VITT and other forms of thrombotic thrombocytopenic syndromes, specifically that of heparin-induced thrombocytopenia, which involves the formation of anti-PF4 antibodies and the activation of platelets leading to thrombocytopenia and thrombin-mediated clotting. Interestingly, certain differences in the presentation also exist in VITT, and guidelines have been published in recent months to assist clinicians in recognizing VITT to achieve desired outcomes. In this paper, we first discuss the clotting phenomenon in COVID-19 and delineate it from VITT, followed by a review of current knowledge on the clinical manifestations of VITT in lieu of other thrombotic thrombocytopenic syndromes. Likewise, emerging evidence on the role of adenoviral vectors and vaccine constituents is also discussed briefly. |
| first_indexed | 2024-03-09T16:21:56Z |
| format | Article |
| id | doaj.art-b05a4a45fa0b438d9415f5ea8c9c88c6 |
| institution | Directory Open Access Journal |
| issn | 2038-8330 |
| language | English |
| last_indexed | 2024-03-09T16:21:56Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Hematology Reports |
| spelling | doaj.art-b05a4a45fa0b438d9415f5ea8c9c88c62023-11-24T15:13:03ZengMDPI AGHematology Reports2038-83302022-12-0114435837210.3390/hematolrep14040050COVID-19 Adenoviral Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT), COVID-19-Related Thrombosis, and the Thrombotic Thrombocytopenic SyndromesGewil Daniella Olipas Allas0Joekeem Del Rosario Arizala1Rafael Vincent Mercado Manalo2Department of Biochemistry, The Graduate Center, The City University of New York (CUNY), New York, NY 10016, USADepartment of Biochemistry, The Graduate Center, The City University of New York (CUNY), New York, NY 10016, USADepartment of Biochemistry and Molecular Biology, College of Medicine, University of the Philippines Manila, Ermita, Manila 1000, PhilippinesAdenoviral-based vaccines such as ChadoX1 CoV-19 (AstraZeneca) and Ad26.COV2.S (J&J) were developed to prevent infection and reduce hospitalization or death in Coronavirus Disease 2019 (COVID-19) patients. Although these vaccines passed safety and efficacy trials with excellent neutralizing capabilities against SARS-CoV-2, very rare reports of acute thrombotic thrombocytopenic events following administration emerged in certain populations, which triggered a series of clinical investigations that gave rise to a novel phenomenon called vaccine-induced immune thrombotic thrombocytopenia (VITT). Several converging pathways exist between VITT and other forms of thrombotic thrombocytopenic syndromes, specifically that of heparin-induced thrombocytopenia, which involves the formation of anti-PF4 antibodies and the activation of platelets leading to thrombocytopenia and thrombin-mediated clotting. Interestingly, certain differences in the presentation also exist in VITT, and guidelines have been published in recent months to assist clinicians in recognizing VITT to achieve desired outcomes. In this paper, we first discuss the clotting phenomenon in COVID-19 and delineate it from VITT, followed by a review of current knowledge on the clinical manifestations of VITT in lieu of other thrombotic thrombocytopenic syndromes. Likewise, emerging evidence on the role of adenoviral vectors and vaccine constituents is also discussed briefly.https://www.mdpi.com/2038-8330/14/4/50thrombocytopeniaVITTHITTTPCOVID-19 |
| spellingShingle | Gewil Daniella Olipas Allas Joekeem Del Rosario Arizala Rafael Vincent Mercado Manalo COVID-19 Adenoviral Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT), COVID-19-Related Thrombosis, and the Thrombotic Thrombocytopenic Syndromes Hematology Reports thrombocytopenia VITT HIT TTP COVID-19 |
| title | COVID-19 Adenoviral Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT), COVID-19-Related Thrombosis, and the Thrombotic Thrombocytopenic Syndromes |
| title_full | COVID-19 Adenoviral Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT), COVID-19-Related Thrombosis, and the Thrombotic Thrombocytopenic Syndromes |
| title_fullStr | COVID-19 Adenoviral Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT), COVID-19-Related Thrombosis, and the Thrombotic Thrombocytopenic Syndromes |
| title_full_unstemmed | COVID-19 Adenoviral Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT), COVID-19-Related Thrombosis, and the Thrombotic Thrombocytopenic Syndromes |
| title_short | COVID-19 Adenoviral Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT), COVID-19-Related Thrombosis, and the Thrombotic Thrombocytopenic Syndromes |
| title_sort | covid 19 adenoviral vaccine induced immune thrombotic thrombocytopenia vitt covid 19 related thrombosis and the thrombotic thrombocytopenic syndromes |
| topic | thrombocytopenia VITT HIT TTP COVID-19 |
| url | https://www.mdpi.com/2038-8330/14/4/50 |
| work_keys_str_mv | AT gewildaniellaolipasallas covid19adenoviralvaccineinducedimmunethromboticthrombocytopeniavittcovid19relatedthrombosisandthethromboticthrombocytopenicsyndromes AT joekeemdelrosarioarizala covid19adenoviralvaccineinducedimmunethromboticthrombocytopeniavittcovid19relatedthrombosisandthethromboticthrombocytopenicsyndromes AT rafaelvincentmercadomanalo covid19adenoviralvaccineinducedimmunethromboticthrombocytopeniavittcovid19relatedthrombosisandthethromboticthrombocytopenicsyndromes |