Abstract
Background: Vaccine induced immune mediated thrombocytopenia or VITT, is a recent and rare phenomenon of thrombosis with thrombocytopenia, frequently including cerebral venous thromboses (CVT), that has been described following vaccination with adenovirus vaccines ChAdOx1 nCOV-19 (AstraZeneca) and Ad26.COV2·S Johnson and Johnson (Janssen/J&J). The evaluation and management of suspected cases of CVT post COVID-19 vaccination are critical skills for a broad range of healthcare providers. Methods: A collaborative comprehensive review of literature was conducted among a global group of expert neurologists and hematologists. Findings: Strategies for rapid evaluation and treatment of the CVT in the context of possible VITT exist, including inflammatory marker measurements, PF4 assays, and non-heparin anticoagulation.
Original language | English (US) |
---|---|
Article number | 117532 |
Journal | Journal of the Neurological Sciences |
Volume | 427 |
DOIs | |
State | Published - Aug 15 2021 |
Externally published | Yes |
Keywords
- COVID-19
- Cerebral venous thrombosis
- Vaccination
ASJC Scopus subject areas
- Neurology
- Clinical Neurology
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Clinical review of cerebral venous thrombosis in the context of COVID-19 vaccinations : Evaluation, management, and scientific questions. / Thakur, Kiran T.; Tamborska, Arina; Wood, Greta K.; McNeill, Emily; Roh, David; Akpan, Imo J.; Miller, Eliza C.; Bautista, Alyssa; Claassen, Jan; Kim, Carla Y.; Guekht, Alla; Pardo, Carlos A.; Williams, Olajide; García-Azorín, David; Prasad, Kameshwar; Schmutzhard, Erich; Michael, Benedict D.; Chou, Sherry H.Y.; Winkler, Andrea S.; Solomon, Tom; Elkind, Mitchell S.
In: Journal of the Neurological Sciences, Vol. 427, 117532, 15.08.2021.Research output: Contribution to journal › Review article › peer-review
TY - JOUR
T1 - Clinical review of cerebral venous thrombosis in the context of COVID-19 vaccinations
T2 - Evaluation, management, and scientific questions
AU - Thakur, Kiran T.
AU - Tamborska, Arina
AU - Wood, Greta K.
AU - McNeill, Emily
AU - Roh, David
AU - Akpan, Imo J.
AU - Miller, Eliza C.
AU - Bautista, Alyssa
AU - Claassen, Jan
AU - Kim, Carla Y.
AU - Guekht, Alla
AU - Pardo, Carlos A.
AU - Williams, Olajide
AU - García-Azorín, David
AU - Prasad, Kameshwar
AU - Schmutzhard, Erich
AU - Michael, Benedict D.
AU - Chou, Sherry H.Y.
AU - Winkler, Andrea S.
AU - Solomon, Tom
AU - Elkind, Mitchell S.
N1 - Funding Information: KTT is a member of the World Health Organization (WHO) working group on clinical guidance of VITT in the context of COVID-19 vaccinations, reports funding from the National Institute of Health (NIH) and Center for Disease Control and Prevention (CDC) on neurological conditions in the context of COVID-19 and COVID-19 vaccinations. AT receives funding from the National Institute for Health Research (NIHR) Academic Clinical Fellowship. DR reports funding from the National Blood Foundation, NIH, National Institute of Allergies and Infectious Disease (NIAID), Department of Defense (DOD), and Apellis Pharmaceuticals. ECM reports funding from the NIH, National Institute of Neurological Disorders and Stroke (NINDS), National Institute on Aging (NIA), and the Louis V. Gerstner, Jr. Foundation (Gerstner Scholars Program). JC reports funding from the NINDS and the McDonnell Foundation. AG reports funding from the Russian Scientific Foundation. CAP reports funding from the NIH and Bart McLean Fund for Neuroimmunology Research. DGA reports funding from the Spanish Society of Neurology, Fundaci?n Estudios de Ciencias de la Salud de Castilla y Le?n, Colegio de M?dicos de Valladolid, the International Headache Society and the WHO. BDM reports funding from the United Kingdom Research Institute / Medical Research Council (UKRI/MRC) and Wellcome. SHYC reports funding from the NIH, NINDS, National Center for Advancing Translational Sciences (NCATS), and the University of Pittsburgh School of Medicine Dean's Faculty Advancement Award. ASW reports funding from the German Federal Ministry of Education and Research and the European Union (EU). TS was Chair/Co-Chair of the United Kingdom Research and Innovation / National Institute for Health Research COVID-19 Rapid Response and Rolling Funding Initiatives (which funded the development of COVID-19 vaccines), is an Advisor to the UK COVID-19 Therapeutics Advisory Panel and a member of the UK Medicines and Healthcare Products Regulatory Agency COVID-19 Vaccines Benefit Risk Expert Working Group. TS is supported by the National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, NIHR Programme Grant for Applied Research, NIHR Global Health Research Group on Brain Infections, the UK Medical Research Council's Global Effort on COVID-19 Programme, and the European Union?s Horizon 2020 research and innovation program ZikaPLAN (Preparedness Latin America Network). MSE reports royalties for a chapter on COVID-19 and neurological disease in UpToDate. All other authors declare no competing interests. Funding Information: KTT is a member of the World Health Organization (WHO) working group on clinical guidance of VITT in the context of COVID-19 vaccinations, reports funding from the National Institute of Health (NIH) and Center for Disease Control and Prevention (CDC) on neurological conditions in the context of COVID-19 and COVID-19 vaccinations. AT receives funding from the National Institute for Health Research (NIHR) Academic Clinical Fellowship. DR reports funding from the National Blood Foundation, NIH, National Institute of Allergies and Infectious Disease (NIAID), Department of Defense (DOD), and Apellis Pharmaceuticals. ECM reports funding from the NIH, National Institute of Neurological Disorders and Stroke (NINDS), National Institute on Aging (NIA), and the Louis V. Gerstner, Jr. Foundation (Gerstner Scholars Program). JC reports funding from the NINDS and the McDonnell Foundation. AG reports funding from the Russian Scientific Foundation. CAP reports funding from the NIH and Bart McLean Fund for Neuroimmunology Research. DGA reports funding from the Spanish Society of Neurology, Fundación Estudios de Ciencias de la Salud de Castilla y León, Colegio de Médicos de Valladolid, the International Headache Society and the WHO. BDM reports funding from the United Kingdom Research Institute / Medical Research Council (UKRI/MRC) and Wellcome. SHYC reports funding from the NIH, NINDS, National Center for Advancing Translational Sciences (NCATS), and the University of Pittsburgh School of Medicine Dean's Faculty Advancement Award. ASW reports funding from the German Federal Ministry of Education and Research and the European Union (EU). TS was Chair/Co-Chair of the United Kingdom Research and Innovation / National Institute for Health Research COVID-19 Rapid Response and Rolling Funding Initiatives (which funded the development of COVID-19 vaccines), is an Advisor to the UK COVID-19 Therapeutics Advisory Panel and a member of the UK Medicines and Healthcare Products Regulatory Agency COVID-19 Vaccines Benefit Risk Expert Working Group. TS is supported by the National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, NIHR Programme Grant for Applied Research, NIHR Global Health Research Group on Brain Infections, the UK Medical Research Council's Global Effort on COVID-19 Programme, and the European Union‘s Horizon 2020 research and innovation program ZikaPLAN (Preparedness Latin America Network). MSE reports royalties for a chapter on COVID-19 and neurological disease in UpToDate. All other authors declare no competing interests. Publisher Copyright: © 2021 The Authors
PY - 2021/8/15
Y1 - 2021/8/15
N2 - Background: Vaccine induced immune mediated thrombocytopenia or VITT, is a recent and rare phenomenon of thrombosis with thrombocytopenia, frequently including cerebral venous thromboses (CVT), that has been described following vaccination with adenovirus vaccines ChAdOx1 nCOV-19 (AstraZeneca) and Ad26.COV2·S Johnson and Johnson (Janssen/J&J). The evaluation and management of suspected cases of CVT post COVID-19 vaccination are critical skills for a broad range of healthcare providers. Methods: A collaborative comprehensive review of literature was conducted among a global group of expert neurologists and hematologists. Findings: Strategies for rapid evaluation and treatment of the CVT in the context of possible VITT exist, including inflammatory marker measurements, PF4 assays, and non-heparin anticoagulation.
AB - Background: Vaccine induced immune mediated thrombocytopenia or VITT, is a recent and rare phenomenon of thrombosis with thrombocytopenia, frequently including cerebral venous thromboses (CVT), that has been described following vaccination with adenovirus vaccines ChAdOx1 nCOV-19 (AstraZeneca) and Ad26.COV2·S Johnson and Johnson (Janssen/J&J). The evaluation and management of suspected cases of CVT post COVID-19 vaccination are critical skills for a broad range of healthcare providers. Methods: A collaborative comprehensive review of literature was conducted among a global group of expert neurologists and hematologists. Findings: Strategies for rapid evaluation and treatment of the CVT in the context of possible VITT exist, including inflammatory marker measurements, PF4 assays, and non-heparin anticoagulation.
KW - COVID-19
KW - Cerebral venous thrombosis
KW - Vaccination
UR - http://www.scopus.com/inward/record.url?scp=85107730447&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85107730447&partnerID=8YFLogxK
U2 - 10.1016/j.jns.2021.117532
DO - 10.1016/j.jns.2021.117532
M3 - Review article
C2 - 34134058
AN - SCOPUS:85107730447
VL - 427
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
M1 - 117532
ER -