Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries

Imagem de Miniatura
Arquivos
art_MUNCKHOF_Cerebral_venous_sinus_thrombosis_due_to_vaccineinduced_immune_2023.PDF (425.49 KB)
Citações na Scopus
1
Tipo de produção
article
Data de publicação
2023
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
SAGE PUBLICATIONS LTD
Autores
MUNCKHOF, Anita van de
BORHANI-HAGHIGHI, Afshin
AARON, Sanjith
KRZYWICKA, Katarzyna
KAMMEN, Mayte Sanchez van
CORDONNIER, Charlotte
KLEINIG, Timothy J.
FIELD, Thalia S.
POLI, Sven
LEMMENS, Robin
Citação
INTERNATIONAL JOURNAL OF STROKE, v.18, n.9, p.1112-1120, 2023
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs. Aims: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs. Methods: We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs). Results: Until August 2022, 228 CVST cases were reported, of which 63 were from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these 63, 32 (51%) met the VITT criteria, compared to 103 of 165 (62%) from HICs. Only 5 of the 32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-platelet factor 4 antibodies were often not tested. The median age was 26 (interquartile range [IQR] 20-37) versus 47 (IQR 32-58) years, and the proportion of women was 25 of 32 (78%) versus 77 of 103 (75%) in MICs versus HICs, respectively. Patients from MICs were diagnosed later than patients from HICs (1/32 [3%] vs. 65/103 [63%] diagnosed before May 2021). Clinical manifestations, including intracranial hemorrhage, were largely similar as was intravenous immunoglobulin use. In-hospital mortality was lower in MICs (7/31 [23%, 95% confidence interval (CI) 11-40]) than in HICs (44/102 [43%, 95% CI 34-53], p = 0.039). Conclusions: The number of CVST-VITT cases reported from LMICs was small despite the widespread use of adenoviral vaccines. Clinical manifestations and treatment of CVST-VITT cases were largely similar in MICs and HICs, while mortality was lower in patients from MICs.
Palavras-chave
CVST, VITT, COVID-19, vaccination, global health, thrombosis
URI
https://observatorio.fm.usp.br/handle/OPI/58204
Referências
  1. Boonyawat K, 2022, RES PRACT THROMB HAE, V6, DOI 10.1002/rth2.12644
  2. Brighton Collaboration, 2021, INT CAS DEF THROMB T
  3. Buoninfante A, 2022, NPJ VACCINES, V7, DOI 10.1038/s41541-022-00569-8
  4. CoWIN, 2021, COWIN DASHB
  5. Ferro JM, 2004, STROKE, V35, P664, DOI 10.1161/01.STR.0000117571.76197.26
  6. Hallberg P, 2019, EBIOMEDICINE, V40, P595, DOI 10.1016/j.ebiom.2019.01.041
  7. Krzywicka K, 2022, NEUROLOGY, V98, pE759, DOI 10.1212/WNL.0000000000013148
  8. Mathieu E, 2021, NAT HUM BEHAV, V5, P947, DOI 10.1038/s41562-021-01122-8
  9. Mouta Nunes de Oliveira P., 2022, VACCINE, V40, P4788, DOI [10.1016/j.vaccine.2022.06.014, DOI 10.1016/J.VACCINE.2022.06.014]
  10. N'kaoua E, 2022, REV NEUROL-FRANCE, V178, P616, DOI 10.1016/j.neurol.2021.10.004
  11. Olsson S, 2015, EXPERT REV CLIN PHAR, V8, P449, DOI 10.1586/17512433.2015.1053391
  12. Pavord S, 2021, NEW ENGL J MED, V385, P1680, DOI 10.1056/NEJMoa2109908
  13. Schultz NH, 2021, NEW ENGL J MED, V384, P2124, DOI [10.1056/NEJMoa2104840, 10.1056/NEJMoa2104882]
  14. Scutelnic A, 2022, ANN NEUROL, V92, P562, DOI 10.1002/ana.26431
  15. See I, 2022, ANN INTERN MED, V175, P513, DOI 10.7326/M21-4502
  16. Siegal DM, 2021, CARDIOVASC RES, V117, P576, DOI 10.1093/cvr/cvaa044
  17. Soboleva K, 2022, LANCET GLOB HEALTH, V10, pE27, DOI 10.1016/S2214-109X(21)00545-3
  18. The World Bank Group, 2022, WORLD BANK OPEN DATA
  19. UNICEF, 2022, COVID-19 market Dashboard
  20. van de Munckhof A, 2022, EUR J NEUROL, V29, P339, DOI 10.1111/ene.15113
  21. van Kammen MS, 2021, JAMA NEUROL, V78, P1314, DOI 10.1001/jamaneurol.2021.3619
  22. Vaughan Leslie J, 2019, Am J Manag Care, V25, pS105
  23. Wasay M, 2014, NAT REV NEUROL, V10, P135, DOI 10.1038/nrneurol.2014.13
  24. Weibel D, 2018, VACCINE, V36, P6202, DOI 10.1016/j.vaccine.2018.08.008
  25. World Health Organization, 2022, VACC EQ
  26. Wouters OJ, 2021, LANCET, V397, P1023, DOI 10.1016/S0140-6736(21)00306-8
  27. Yamey G, 2022, BMJ-BRIT MED J, V376, DOI 10.1136/bmj-2022-070650
  28. Zhou LW., 2022, STROKE, V54, P169

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - COVID-19
Artigos e Materiais de Revistas Científicas - LIM/15
Artigos e Materiais de Revistas Científicas - ODS/03