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Thromboembolism after COVID-19 vaccine in patients with preexisting thrombocytopenia.

Department of Experimental Medicine, TOR, University of Rome Tor Vergata, 00133, Rome, Italy. alessandro.mauriello@uniroma2.it. Department of Experimental Medicine, TOR, University of Rome Tor Vergata, 00133, Rome, Italy. School of Life Sciences, University of Nottingham, Nottingham, UK. Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy. Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133, Rome, Italy. Laboratory of Cell Engineering, Institute of Biotechnology; Research Unit of Cell Death Mechanism, Chinese Academy of Medical Science, 2020RU009, 20 Dongda Street, Beijing, 100071, China. Institute of Nutrition and Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China. The Third Affiliated Hospital of Soochow University, Changzhou, China. The Child Health Institute of New Jersey, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA. Institutes for Translational Medicine, Soochow University, Suzhou, China. Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133, Rome, Italy. novelli@med.uniroma2.it. IRCCS Neuromed, Pozzilli, IS, Italy. novelli@med.uniroma2.it. Department of Pharmacology, School of Medicine, University of Nevada, Reno, NV, 89557, USA. novelli@med.uniroma2.it. Department of Experimental Medicine, TOR, University of Rome Tor Vergata, 00133, Rome, Italy. melino@uniroma2.it. DZNE German Center for Neurodegenerative Diseases, Bonn, Germany. melino@uniroma2.it.

Cell death & disease. 2021;(8):762
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Abstract

While vaccination is the single most effective intervention to drastically reduce severe disease and death following SARS-CoV-2 infection, as shown in UK and Israel, some serious concerns have been raised for an unusual adverse drug reaction (ADR), including vaccine-induced immune thrombotic thrombocytopenia (VITT) with concurrent low platelets as well as capillary leak syndrome. In fact, the overall safety of the vaccine is highlighted by the low frequency of ADR considering that in UK, by the early June, 40 million first doses and 29 million second doses have been injected; nonetheless, 390 thrombotic events, including 71 fatal events have been reported. Interestingly, the cases reported low platelet counts with the presence of anti-platelet factor-4 (PF4) antibodies, indicating an abnormal clotting reaction. Here, out of three referred cases, we report a post-vaccine clinical case of fatal thrombosis with postmortem examination and whole exome sequencing (WES) analysis, whose pathogenesis appeared associated to a preexisting condition of thrombocytopenia due to myelodysplasia.

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Publication Type : Case Reports

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