Cell Death and Disease (Aug 2021)

Thromboembolism after COVID-19 vaccine in patients with preexisting thrombocytopenia

  • Alessandro Mauriello,
  • Manuel Scimeca,
  • Ivano Amelio,
  • Renato Massoud,
  • Antonio Novelli,
  • Francesca Di Lorenzo,
  • Susanna Finocchiaro,
  • Carolina Cimino,
  • Rossana Telesca,
  • Marcello Chiocchi,
  • Qiang Sun,
  • Ying Wang,
  • Yufang Shi,
  • Giuseppe Novelli,
  • Gerry Melino

DOI
https://doi.org/10.1038/s41419-021-04058-z
Journal volume & issue
Vol. 12, no. 8
pp. 1 – 6

Abstract

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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.