Vaccine-induced immune thrombotic thrombocytopenia with disseminated intravascular coagulation and death following the ChAdOx1 nCoV-19 vaccine
Open accessAbstract
Coronavirus is a novel human pathogen causing fulminant respiratory syndrome (COVID-19). Although COVID-19 is primarily a disease of the lungs with florid respiratory manifestations, there are increasing reports of cardiovascular, musculoskeletal, gastrointestinal, and thromboembolic complications. Developing an effective and reliable vaccine was emergently pursued to control the catastrophic spread of the global pandemic. We report a fatal case of vaccine-induced immune thrombotic thrombocytopenia (VITT) after receiving the first dose of the ChAdOx1 nCoV-19 vaccine. We attribute this fatal thrombotic condition to the vaccine due to the remarkable temporal relationship. The proposed mechanism of VITT is production of rogue antibodies against platelet factor-4 resulting in massive platelet aggregation. Healthcare providers should be aware of the possibility of such fatal complication, and the vaccine recipients should be warned about the symptoms of VITT.
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- Authors
- Aladdin, Y., Algahtani, H., & Shirah, B.
- Affiliations
- King Saud bin Abdulaziz University for Health Sciences (SA)
- Corresponding author
- Aladdin, Yasser
- Algahtani, Hussein
- Shirah, Bader
- Venue
- Journal of Stroke and Cerebrovascular Diseases
- Publisher
- Elsevier BV
- Published
- 2021-09
- Volume
- 30
- Issue
- 9
- Pages
- 105938
- ISSN
- 1052-3057 (ISSN-L)
- PMC
- PMC8219525
- OpenAlex
- W3175154538
- Cited by
- 48
- References
- 18
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 6 · 2023: 7 · 2022: 19 · 2021: 9
- FWCI
- 9.62
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Stroke and Cerebrovascular Diseases (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Heparin-Induced Thrombocytopenia and Thrombosis
- Health Sciences › Medicine › Hematology › Platelet Disorders and Treatments
- Life Sciences › Immunology and Microbiology › Immunology › Complement system in diseases
- Keywords
- vaccine-induced immune thrombotic thrombocytopenia, ChAdOx1 nCoV-19 vaccine, AstraZeneca COVID-19 vaccine, disseminated intravascular coagulation, platelet factor 4 antibodies, platelet aggregation, COVID-19 vaccine safety, thromboembolic events
- MeSH terms
- COVID-19 Vaccines, ChAdOx1 nCoV-19, Adult, Disseminated Intravascular Coagulation, Female, Humans, Purpura, Thrombotic Thrombocytopenic, Vaccination, Treatment Outcome, Fatal Outcome, Sagittal Sinus Thrombosis
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