Only Subclinical Alterations in the Haemostatic System of People with Diabetes after COVID-19 Vaccination
Margret Paar,
Faisal Aziz,
Caren Sourij,
Norbert J. Tripolt,
Harald Kojzar,
Alexander Müller,
Peter Pferschy,
Anna Obermayer,
Tamara Banfic,
Bruno Di Geronimo Quintero,
Nandu Goswami,
Axel Schlagenhauf,
Martin Köstenberger,
Thomas Bärnthaler,
Thomas Wagner,
Andelko Hrzenjak,
Willibald Wonisch,
Gilbert Reibnegger,
Reinhard B. Raggam,
Harald Sourij,
Gerhard Cvirn
Affiliations
Margret Paar
Division of Medicinal Chemistry, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
Faisal Aziz
Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
Caren Sourij
Division of Cardiology, Medical University of Graz, 8010 Graz, Austria
Norbert J. Tripolt
Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
Harald Kojzar
Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
Alexander Müller
Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
Peter Pferschy
Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
Anna Obermayer
Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
Tamara Banfic
Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
Bruno Di Geronimo Quintero
Division of Medicinal Chemistry, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
Nandu Goswami
Division of Physiology, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
Axel Schlagenhauf
Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, 8010 Graz, Austria
Martin Köstenberger
Department of Pediatrics and Adolescent Medicine, Division of General Pediatrics, Medical University of Graz, 8010 Graz, Austria
Thomas Bärnthaler
Division of Pharmacology, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
Thomas Wagner
Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8010 Graz, Austria
Andelko Hrzenjak
Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria
Willibald Wonisch
Division of Medicinal Chemistry, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
Gilbert Reibnegger
Division of Medicinal Chemistry, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
Reinhard B. Raggam
Division of Angiology, Medical University of Graz, 8010 Graz, Austria
Harald Sourij
Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, 8010 Graz, Austria
Gerhard Cvirn
Division of Medicinal Chemistry, Otto Loewi Research Centre for Vascular Biology, Immunology and Inflammation, Medical University of Graz, 8010 Graz, Austria
People with diabetes have an increased risk of experiencing adverse COVID-19 outcomes. COVID-19 vaccination is, therefore, highly recommended. However, people with diabetes have an inherently elevated risk of thrombotic events and the impact of the vaccination on the coagulation system in this patient population remains to be elucidated. The aim of this study was to investigate the impact of COVID-19 vaccination on the haemostatic system in people with type 1 or type 2 diabetes. We evaluated the effects of COVID-19 vaccination (BioNTech Pfizer, Moderna, AstraZeneca) on standard coagulation parameters, whole blood coagulation (Thrombelastometry), platelet function (impedance aggregation), and thrombin generation (calibrated automated thrombography) in people with type 1 diabetes mellitus (n = 41) and type 2 diabetes mellitus (n = 37). Blood sampling points were prior to vaccination and two weeks after the respective vaccination. Thrombelastometry measurements indicated moderately increased clot formation post-vaccination in people with type 1, as well as with type 2, diabetes: “Clot formation times” were significantly shorter, and both “maximum clot firmness” and “alpha angles” were significantly higher, as compared to the respective pre-vaccination values. Therefore, TEM parameters were not altered after vaccination in patients receiving ASA. Moreover, platelet aggregation was enhanced in people with type 1 diabetes, and plasma levels of D-Dimer were increased in people with type 2 diabetes, following COVID-19 vaccination. All other standard coagulation parameters, as well as thrombin generation, were not affected by the vaccination. The coagulation responses of people with diabetes to COVID-19 vaccination were only subclinical and comparable to those observed in healthy individuals. Our findings suggest that people with diabetes do not face an increased activation of the coagulation post-vaccination.
