Background rates of five thrombosis with thrombocytopenia syndromes of special interest for COVID-19 vaccine safety surveillance: Incidence between 2017 and 2019 and patient profiles from 38.6 million people in six European countries

<p><strong>Background:&nbsp;</strong>Thrombosis with thrombocytopenia syndrome (TTS) has been reported among individuals vaccinated with adenovirus-vectored COVID-19 vaccines. In this study, we describe the background incidence of non-vaccine induced TTS in six European countri...

Full description

Bibliographic Details
Main Authors: Burn, E, Li, X, Kostka, K, Stewart, HM, Reich, C, Seager, S, Duarte-Salles, T, Fernandez-Bertolin, S, Aragón, M, Reyes, C, Martinez-Hernandez, E, Marti, E, Delmestri, A, Verhamme, K, Rijnbeek, P, Horban, S, Morales, DR, Prieto-Alhambra, D
Format: Journal article
Language:English
Published: Wiley 2022
_version_ 1797108934910148608
author Burn, E
Li, X
Kostka, K
Stewart, HM
Reich, C
Seager, S
Duarte-Salles, T
Fernandez-Bertolin, S
Aragón, M
Reyes, C
Martinez-Hernandez, E
Marti, E
Delmestri, A
Verhamme, K
Rijnbeek, P
Horban, S
Morales, DR
Prieto-Alhambra, D
author_facet Burn, E
Li, X
Kostka, K
Stewart, HM
Reich, C
Seager, S
Duarte-Salles, T
Fernandez-Bertolin, S
Aragón, M
Reyes, C
Martinez-Hernandez, E
Marti, E
Delmestri, A
Verhamme, K
Rijnbeek, P
Horban, S
Morales, DR
Prieto-Alhambra, D
author_sort Burn, E
collection OXFORD
description <p><strong>Background:&nbsp;</strong>Thrombosis with thrombocytopenia syndrome (TTS) has been reported among individuals vaccinated with adenovirus-vectored COVID-19 vaccines. In this study, we describe the background incidence of non-vaccine induced TTS in six European countries.</p> <p><strong>Methods:&nbsp;</strong>Electronic medical records from France, the Netherlands, Italy, Germany, Spain, and the United Kingdom informed the study. Incidence rates of cerebral venous sinus thrombosis (CVST), splanchnic vein thrombosis (SVT), deep vein thrombosis (DVT), pulmonary embolism (PE), and myocardial infarction or ischemic stroke, all with concurrent thrombocytopenia, were estimated among the general population of persons in a database between 2017 and 2019. A range of additional potential adverse events of special interest for COVID-19 vaccinations were also studied in a similar manner.</p> <p><strong>Findings:&nbsp;</strong>A total of 38&thinsp;611&thinsp;617 individuals were included. Background rates ranged from 1.0 (95% CI: 0.7&ndash;1.4) to 8.5 (7.4&ndash;9.9) per 100&thinsp;000 person-years for DVT with thrombocytopenia, from 0.5 (0.3&ndash;0.6) to 20.8 (18.9&ndash;22.8) for PE with thrombocytopenia, from 0.1 (0.0&ndash;0.1) to 2.5 (2.2&ndash;2.7) for SVT with thrombocytopenia, and from 1.0 (0.8&ndash;1.2) to 43.4 (40.7&ndash;46.3) for myocardial infarction or ischemic stroke with thrombocytopenia. CVST with thrombocytopenia was only identified in one database, with incidence rate of 0.1 (0.1&ndash;0.2) per 100&thinsp;000 person-years. The incidence of non-vaccine induced TTS increased with age, and was typically greater among those with more comorbidities and greater medication use than the general population. It was also more often seen in men than women. A large proportion of those affected were seen to have been taking antithrombotic and anticoagulant therapies prior to their event.</p> <p><strong>Interpretation:&nbsp;</strong>Although rates vary across databases, non-vaccine induced TTS has consistently been seen to be a very rare event among the general population. While still remaining very rare, rates were typically higher among older individuals, and those affected were also seen to generally be male and have more comorbidities and greater medication use than the general population.</p>
first_indexed 2024-03-07T07:34:59Z
format Journal article
id oxford-uuid:78c4748f-4fff-4468-b15f-e08cdbc6f4ef
institution University of Oxford
language English
last_indexed 2024-03-07T07:34:59Z
publishDate 2022
publisher Wiley
record_format dspace
spelling oxford-uuid:78c4748f-4fff-4468-b15f-e08cdbc6f4ef2023-02-27T10:55:58ZBackground rates of five thrombosis with thrombocytopenia syndromes of special interest for COVID-19 vaccine safety surveillance: Incidence between 2017 and 2019 and patient profiles from 38.6 million people in six European countries Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:78c4748f-4fff-4468-b15f-e08cdbc6f4efEnglishSymplectic ElementsWiley2022Burn, ELi, XKostka, KStewart, HMReich, CSeager, SDuarte-Salles, TFernandez-Bertolin, SAragón, MReyes, CMartinez-Hernandez, EMarti, EDelmestri, AVerhamme, KRijnbeek, PHorban, SMorales, DRPrieto-Alhambra, D<p><strong>Background:&nbsp;</strong>Thrombosis with thrombocytopenia syndrome (TTS) has been reported among individuals vaccinated with adenovirus-vectored COVID-19 vaccines. In this study, we describe the background incidence of non-vaccine induced TTS in six European countries.</p> <p><strong>Methods:&nbsp;</strong>Electronic medical records from France, the Netherlands, Italy, Germany, Spain, and the United Kingdom informed the study. Incidence rates of cerebral venous sinus thrombosis (CVST), splanchnic vein thrombosis (SVT), deep vein thrombosis (DVT), pulmonary embolism (PE), and myocardial infarction or ischemic stroke, all with concurrent thrombocytopenia, were estimated among the general population of persons in a database between 2017 and 2019. A range of additional potential adverse events of special interest for COVID-19 vaccinations were also studied in a similar manner.</p> <p><strong>Findings:&nbsp;</strong>A total of 38&thinsp;611&thinsp;617 individuals were included. Background rates ranged from 1.0 (95% CI: 0.7&ndash;1.4) to 8.5 (7.4&ndash;9.9) per 100&thinsp;000 person-years for DVT with thrombocytopenia, from 0.5 (0.3&ndash;0.6) to 20.8 (18.9&ndash;22.8) for PE with thrombocytopenia, from 0.1 (0.0&ndash;0.1) to 2.5 (2.2&ndash;2.7) for SVT with thrombocytopenia, and from 1.0 (0.8&ndash;1.2) to 43.4 (40.7&ndash;46.3) for myocardial infarction or ischemic stroke with thrombocytopenia. CVST with thrombocytopenia was only identified in one database, with incidence rate of 0.1 (0.1&ndash;0.2) per 100&thinsp;000 person-years. The incidence of non-vaccine induced TTS increased with age, and was typically greater among those with more comorbidities and greater medication use than the general population. It was also more often seen in men than women. A large proportion of those affected were seen to have been taking antithrombotic and anticoagulant therapies prior to their event.</p> <p><strong>Interpretation:&nbsp;</strong>Although rates vary across databases, non-vaccine induced TTS has consistently been seen to be a very rare event among the general population. While still remaining very rare, rates were typically higher among older individuals, and those affected were also seen to generally be male and have more comorbidities and greater medication use than the general population.</p>
spellingShingle Burn, E
Li, X
Kostka, K
Stewart, HM
Reich, C
Seager, S
Duarte-Salles, T
Fernandez-Bertolin, S
Aragón, M
Reyes, C
Martinez-Hernandez, E
Marti, E
Delmestri, A
Verhamme, K
Rijnbeek, P
Horban, S
Morales, DR
Prieto-Alhambra, D
Background rates of five thrombosis with thrombocytopenia syndromes of special interest for COVID-19 vaccine safety surveillance: Incidence between 2017 and 2019 and patient profiles from 38.6 million people in six European countries
title Background rates of five thrombosis with thrombocytopenia syndromes of special interest for COVID-19 vaccine safety surveillance: Incidence between 2017 and 2019 and patient profiles from 38.6 million people in six European countries
title_full Background rates of five thrombosis with thrombocytopenia syndromes of special interest for COVID-19 vaccine safety surveillance: Incidence between 2017 and 2019 and patient profiles from 38.6 million people in six European countries
title_fullStr Background rates of five thrombosis with thrombocytopenia syndromes of special interest for COVID-19 vaccine safety surveillance: Incidence between 2017 and 2019 and patient profiles from 38.6 million people in six European countries
title_full_unstemmed Background rates of five thrombosis with thrombocytopenia syndromes of special interest for COVID-19 vaccine safety surveillance: Incidence between 2017 and 2019 and patient profiles from 38.6 million people in six European countries
title_short Background rates of five thrombosis with thrombocytopenia syndromes of special interest for COVID-19 vaccine safety surveillance: Incidence between 2017 and 2019 and patient profiles from 38.6 million people in six European countries
title_sort background rates of five thrombosis with thrombocytopenia syndromes of special interest for covid 19 vaccine safety surveillance incidence between 2017 and 2019 and patient profiles from 38 6 million people in six european countries
work_keys_str_mv AT burne backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT lix backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT kostkak backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT stewarthm backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT reichc backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT seagers backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT duartesallest backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT fernandezbertolins backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT aragonm backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT reyesc backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT martinezhernandeze backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT martie backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT delmestria backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT verhammek backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT rijnbeekp backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT horbans backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT moralesdr backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries
AT prietoalhambrad backgroundratesoffivethrombosiswiththrombocytopeniasyndromesofspecialinterestforcovid19vaccinesafetysurveillanceincidencebetween2017and2019andpatientprofilesfrom386millionpeopleinsixeuropeancountries