tetano
Editor, Senior Moderator
Front Med
. 2024 Jul 3.
doi: 10.1007/s11684-023-1054-2. Online ahead of print. Acquired immune thrombotic thrombocytopenic purpura (TTP) associated with inactivated COVID-19 vaccine CoronaVac
Zhangbiao Long[SUP] #[/SUP][SUP] 1 [/SUP], Suyu Jiang[SUP] #[/SUP][SUP] 2 [/SUP], Honglei Xin[SUP] #[/SUP][SUP] 2 [/SUP], Lu Zhang[SUP] 2 [/SUP], Ruinan Lu[SUP] 3 [/SUP], Fengqi Liu[SUP] 3 [/SUP], Yong Xu[SUP] 4 [/SUP], Linv Wang[SUP] 5 [/SUP], Jun Wang[SUP] 6 [/SUP], Xuezhong Zhang[SUP] 7 [/SUP], Hui Liao[SUP] 8 [/SUP], Jinning Shi[SUP] 9 [/SUP], Xue Yan[SUP] 9 [/SUP], Xiang Zhu[SUP] 10 [/SUP], Ruonan Shao[SUP] 2 [/SUP], Zijian Li[SUP] 2 [/SUP], Yilin Zhu[SUP] 2 [/SUP], Han Yan[SUP] 2 [/SUP], Jiao Wu[SUP] 2 [/SUP], Chao Fang[SUP] 11 [/SUP], Xiaodong Xi[SUP] 12 [/SUP], Xiaofeng Shi[SUP] 13 [/SUP]
Affiliations
Corona virus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected the whole world. Acquired thrombotic thrombocytopenic purpura (TTP) has been reported after administration of mRNA- or adenoviral vector-based COVID-19 vaccines, including Ad26.COV2-S, BNT162b2, mRNA-1273, and ChAdOx1 nCov-19. However, whether inactivated vaccines, such as CoronaVac, could cause TTP and whether the symptoms in TTPs caused by inactivated vaccines are different from previously reported cases are unknown. In this study, two cases were reported. Both cases developed TTP after the second CoronaVac vaccination shot, but not the first. They demonstrated symptoms of fever, neurological abnormalities, renal dysfunction, thrombocytopenia, and hemolysis. Both patients achieved complete remission through several sessions of plasma exchanges and immune suppression. The incidence of TTP in Nanjing area was analyzed. The number of patients with TTP was 12 in 2019, 6 in 2020, 16 in 2021, and 19 in 2022. To the authors' knowledge, this report is the first report of TTP associated with inactivated COVID-19 vaccine (CoronaVac). The rarity and delayed onset may be due to the relatively milder immune response caused by the inactivated vaccines than mRNA-based ones. Timely plasma exchange is a vital treatment for CoronaVac-related TTP, similar to activated vaccine-related TTP.
Keywords: CoronaVac; acute respiratory syndrome coronavirus 2 (SARS-CoV-2); corona virus disease 2019 (COVID-19); thrombotic thrombocytopenia purpura (TTP); vaccine.
. 2024 Jul 3.
doi: 10.1007/s11684-023-1054-2. Online ahead of print. Acquired immune thrombotic thrombocytopenic purpura (TTP) associated with inactivated COVID-19 vaccine CoronaVac
Zhangbiao Long[SUP] #[/SUP][SUP] 1 [/SUP], Suyu Jiang[SUP] #[/SUP][SUP] 2 [/SUP], Honglei Xin[SUP] #[/SUP][SUP] 2 [/SUP], Lu Zhang[SUP] 2 [/SUP], Ruinan Lu[SUP] 3 [/SUP], Fengqi Liu[SUP] 3 [/SUP], Yong Xu[SUP] 4 [/SUP], Linv Wang[SUP] 5 [/SUP], Jun Wang[SUP] 6 [/SUP], Xuezhong Zhang[SUP] 7 [/SUP], Hui Liao[SUP] 8 [/SUP], Jinning Shi[SUP] 9 [/SUP], Xue Yan[SUP] 9 [/SUP], Xiang Zhu[SUP] 10 [/SUP], Ruonan Shao[SUP] 2 [/SUP], Zijian Li[SUP] 2 [/SUP], Yilin Zhu[SUP] 2 [/SUP], Han Yan[SUP] 2 [/SUP], Jiao Wu[SUP] 2 [/SUP], Chao Fang[SUP] 11 [/SUP], Xiaodong Xi[SUP] 12 [/SUP], Xiaofeng Shi[SUP] 13 [/SUP]
Affiliations
- PMID: 38958922
- DOI: 10.1007/s11684-023-1054-2
Corona virus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected the whole world. Acquired thrombotic thrombocytopenic purpura (TTP) has been reported after administration of mRNA- or adenoviral vector-based COVID-19 vaccines, including Ad26.COV2-S, BNT162b2, mRNA-1273, and ChAdOx1 nCov-19. However, whether inactivated vaccines, such as CoronaVac, could cause TTP and whether the symptoms in TTPs caused by inactivated vaccines are different from previously reported cases are unknown. In this study, two cases were reported. Both cases developed TTP after the second CoronaVac vaccination shot, but not the first. They demonstrated symptoms of fever, neurological abnormalities, renal dysfunction, thrombocytopenia, and hemolysis. Both patients achieved complete remission through several sessions of plasma exchanges and immune suppression. The incidence of TTP in Nanjing area was analyzed. The number of patients with TTP was 12 in 2019, 6 in 2020, 16 in 2021, and 19 in 2022. To the authors' knowledge, this report is the first report of TTP associated with inactivated COVID-19 vaccine (CoronaVac). The rarity and delayed onset may be due to the relatively milder immune response caused by the inactivated vaccines than mRNA-based ones. Timely plasma exchange is a vital treatment for CoronaVac-related TTP, similar to activated vaccine-related TTP.
Keywords: CoronaVac; acute respiratory syndrome coronavirus 2 (SARS-CoV-2); corona virus disease 2019 (COVID-19); thrombotic thrombocytopenia purpura (TTP); vaccine.