tetano
Editor, Senior Moderator
Res Pract Thromb Haemost
. 2021 Dec 7;5(8):e12630.
doi: 10.1002/rth2.12630. eCollection 2021 Dec.
ChAdOx1 vaccination, blood coagulation, and inflammation: No effect on coagulation but increased interleukin-6
Loes H Willems[SUP] 1 [/SUP], Magdolna Nagy[SUP] 2 [/SUP], Hugo Ten Cate[SUP] 2 3 [/SUP], Henri M H Spronk[SUP] 2 [/SUP], Lotte M C Jacobs[SUP] 1 [/SUP], Josephine Kranendonk[SUP] 1 [/SUP], Maaike van Leeuwen[SUP] 1 [/SUP], Danielle Meijer[SUP] 4 [/SUP], Saskia Middeldorp[SUP] 5 [/SUP], Laszlo A Groh[SUP] 1 [/SUP], Michiel C Warlé[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Vaccination is the leading approach in combatting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. ChAdOx1 nCoV-19 vaccination (ChAdOx1) has been linked to a higher frequency of rare thrombosis and thromboembolism. This study aimed to explore markers related to the blood coagulation system activation and inflammation, before and after ChAdOx1 vaccination.
Patients and methods: An observational cohort study including 40 health care workers. Whole blood samples were collected before, and either 1 or 2 days after vaccination. Activated coagulation factors in complex with their natural inhibitors were determined by custom ELISAs, including thrombin:antithrombin (T:AT), kallikrein:C1-esterase-inhibitor (PKa:C1Inh), factor(F)IXa:AT, FXa:AT, FXIaAT, FXIa:alpha-1-antitrypsin (α1AT), FXIa:C1inh, and FVIIa:AT. Plasma concentrations of interleukin (IL)-6 and IL-18 were quantified via ELISA. Analyses were performed using Wilcoxon signed-rank test.
Results: Levels of FVIIa:AT decreased with a median (IQR) of 707 (549-1028) pg/ml versus 598 (471-996) pg/ml, p = 0.01; and levels of IL-6 increased, 4.0 (1.9-6.8) pg/ml versus 6.9 (3.6-12.2) pg/ml, p = 0.02, after vaccination. No changes were observed in T:AT, PKa:C1Inh, FIXa:AT, FXa:AT, FXIaAT, FXIa:α1AT, FXIa:C1inh, and IL-18.
Conclusion: ChAdOx1 leads to an inflammatory response with increased levels of IL-6. We did not observe activation of the blood coagulation system 1-2 days following vaccination.
Keywords: COVID‐19; COVID‐19 vaccines; SARS‐CoV‐2; blood coagulation; thrombosis; vaccination.
. 2021 Dec 7;5(8):e12630.
doi: 10.1002/rth2.12630. eCollection 2021 Dec.
ChAdOx1 vaccination, blood coagulation, and inflammation: No effect on coagulation but increased interleukin-6
Loes H Willems[SUP] 1 [/SUP], Magdolna Nagy[SUP] 2 [/SUP], Hugo Ten Cate[SUP] 2 3 [/SUP], Henri M H Spronk[SUP] 2 [/SUP], Lotte M C Jacobs[SUP] 1 [/SUP], Josephine Kranendonk[SUP] 1 [/SUP], Maaike van Leeuwen[SUP] 1 [/SUP], Danielle Meijer[SUP] 4 [/SUP], Saskia Middeldorp[SUP] 5 [/SUP], Laszlo A Groh[SUP] 1 [/SUP], Michiel C Warlé[SUP] 1 [/SUP]
Affiliations
- PMID: 34934894
- PMCID: PMC8652129
- DOI: 10.1002/rth2.12630
Abstract
Background: Vaccination is the leading approach in combatting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. ChAdOx1 nCoV-19 vaccination (ChAdOx1) has been linked to a higher frequency of rare thrombosis and thromboembolism. This study aimed to explore markers related to the blood coagulation system activation and inflammation, before and after ChAdOx1 vaccination.
Patients and methods: An observational cohort study including 40 health care workers. Whole blood samples were collected before, and either 1 or 2 days after vaccination. Activated coagulation factors in complex with their natural inhibitors were determined by custom ELISAs, including thrombin:antithrombin (T:AT), kallikrein:C1-esterase-inhibitor (PKa:C1Inh), factor(F)IXa:AT, FXa:AT, FXIaAT, FXIa:alpha-1-antitrypsin (α1AT), FXIa:C1inh, and FVIIa:AT. Plasma concentrations of interleukin (IL)-6 and IL-18 were quantified via ELISA. Analyses were performed using Wilcoxon signed-rank test.
Results: Levels of FVIIa:AT decreased with a median (IQR) of 707 (549-1028) pg/ml versus 598 (471-996) pg/ml, p = 0.01; and levels of IL-6 increased, 4.0 (1.9-6.8) pg/ml versus 6.9 (3.6-12.2) pg/ml, p = 0.02, after vaccination. No changes were observed in T:AT, PKa:C1Inh, FIXa:AT, FXa:AT, FXIaAT, FXIa:α1AT, FXIa:C1inh, and IL-18.
Conclusion: ChAdOx1 leads to an inflammatory response with increased levels of IL-6. We did not observe activation of the blood coagulation system 1-2 days following vaccination.
Keywords: COVID‐19; COVID‐19 vaccines; SARS‐CoV‐2; blood coagulation; thrombosis; vaccination.