J Appl Biomed 20:83-86, 2022 | DOI: 10.32725/jab.2022.011
SARS-CoV-2 vaccination associated venous sinus thrombosis in three patients
- Neurology & Neurophysiology Center, Vienna, Austria
Introduction: There is increasing evidence that vaccinations against the severe acquired respiratory syndrome coronavirus type-2 (SARS-CoV-2) virus can be followed by venous sinus thrombosis (VST). Here we report on three patients who developed VST shortly after SARS-CoV-2 vaccinations. Case series: An 80-year-old male, a 58-year-old male, and a 34-year-old female developed VST 14 to 24 days after the first dose of an mRNA-based SARS-CoV-2 vaccine. All three patients profited from analgesics, heparinisation, and oral anticoagulation, but made only an incomplete recovery at the time of discharge. Arguments for a causal relationship are: VST was time-linked to vaccination in the three patients; VST was previously reported after SARS-CoV-2 vaccination; SARS-CoV-2 infections can be complicated by VST; and SARS-CoV-2 can be associated with hypercoagulability. The fact that no hypercoagulability occurred in a pilot study after SARS-CoV-2 vaccination and that there has been no evidence of an increased prevalence/incidence of VST after vaccination since the introduction of the SARS-CoV-2 vaccination speak against a causal relationship.
Conclusions: SARS-CoV-2 vaccinations can occasionally be followed by a VST. There are more arguments for than against a causal relationship.
Keywords: Coronavirus; COVID-19; Hypercoagulability; SARS-CoV-2; Thrombosis
Conflicts of interest:
The author has no conflict of interests to declare.
Received: February 24, 2022; Revised: June 2, 2022; Accepted: July 19, 2022; Prepublished online: July 26, 2022; Published: October 5, 2022 Show citation
References
- Bikdeli B, Jiménez D, Demelo-Rodriguez P, Galeano-Valle F, Porras JA, Barba R, et al. (2022). Venous Thrombosis within 30 Days after Vaccination against SARS-CoV-2 in a Multinational Venous Thromboembolism Registry. Viruses 14: 178. DOI: 10.3390/v14020178.
Go to original source...
Go to PubMed...
- Burley NB, Dy PS, Kalantri S, Razzaq K (2021). Aortic Thrombosis and Acute Limb Ischemia Secondary to COVID Hypercoagulability. Cureus 13: e16171. DOI: 10.7759/cureus.16171.
Go to original source...
Go to PubMed...
- Campello E, Simion C, Bulato C, Radu CM, Gavasso S, Sartorello F, et al. (2021). Absence of hypercoagulability after nCoV-19 vaccination: An observational pilot study. Thromb Res 205: 24-28. DOI: 10.1016/j.thromres.2021.06.016.
Go to original source...
Go to PubMed...
- Ciccone A (2021). SARS-CoV-2 vaccine-induced cerebral venous thrombosis. Eur J Intern Med 89: 19-21. DOI: 10.1016/j.ejim.2021.05.026.
Go to original source...
Go to PubMed...
- Dakay K, Cooper J, Bloomfield J, Overby P, Mayer SA, Nuoman R, et al. (2021). Cerebral Venous Sinus Thrombosis in COVID-19 Infection: A Case Series and Review of The Literature. J Stroke Cerebrovasc Dis 30: 105434. DOI: 10.1016/j.jstrokecerebrovasdis.2020.105434.
Go to original source...
Go to PubMed...
- Dix C, McFadyen J, Huang A, Chunilal S, Chen V, Tran H (2022). Understanding vaccine-induced thrombotic thrombocytopenia (VITT). Intern Med J 52: 717-723. DOI: 10.1111/imj.15783.
Go to original source...
Go to PubMed...
- Ferro JM, de Sousa DA, Coutinho JM, Martinelli I (2021). European stroke organization interim expert opinion on cerebral venous thrombosis occurring after SARS-CoV-2 vaccination. Eur Stroke J 6: CXVI-CXXI. DOI: 10.1177/23969873211030842.
Go to original source...
Go to PubMed...
- Finsterer J (2022). Neurological side effects of SARS-CoV-2 vaccinations. Acta Neurol Scand 145: 5-9. DOI: 10.1111/ane.13550.
Go to original source...
Go to PubMed...
- Kerr S, Joy M, Torabi F, Bedston S, Akbari A, Agrawal U, et al. (2022). First dose ChAdOx1 and BNT162b2 COVID-19 vaccinations andcerebral venous sinus thrombosis: A pooled self-controlled case series study of 11.6 million individuals in England, Scotland, and Wales. PLoS Med 19: e1003927. DOI: 10.1371/journal.pmed.1003927.
Go to original source...
Go to PubMed...
- Medicherla CB, Pauley RA, de Havenon A, Yaghi S, Ishida K, Torres JL (2020). Cerebral Venous Sinus Thrombosis in the COVID-19 Pandemic. J Neuroophthalmol 40: 457-462. DOI: 10.1097/WNO.0000000000001122.
Go to original source...
Go to PubMed...
- Palaiodimou L, Stefanou MI, Katsanos AH, Aguiar de Sousa D, Coutinho JM, Lagiou P et al. (2021). Cerebral Venous Sinus Thrombosis and Thrombotic Events After Vector-Based COVID-19 Vaccines: A Systematic Review and Meta-analysis. Neurology 97: e2136-e2147. DOI: 10.1212/WNL.0000000000012896.
Go to original source...
Go to PubMed...
- Pang E, Ghosh S, Chemmanam T, Grove C, Phillips T (2022). Cerebral arterial and venous thrombosis due to COVID-19 vaccine-induced immune thrombotic thrombocytopenia. BMJ Case Rep 15: e245445. DOI: 10.1136/bcr-2021-245445.
Go to original source...
Go to PubMed...
- Pawlowski C, Rincón-Hekking J, Awasthi S, Pandey V, Lenehan P, Venkatakrishnan AJ, et al. (2021). Cerebral Venous Sinus Thrombosis is not Significantly Linked to COVID-19 Vaccines or Non-COVID Vaccines in a Large Multi-State Health System. J Stroke Cerebrovasc Dis 30: 105923. DOI: 10.1016/j.jstrokecerebrovasdis.2021.105923.
Go to original source...
Go to PubMed...
- Schulz JB, Berlit P, Diener HC, Gerloff C, Greinacher A, Klein C, et al. (2021). German Society of Neurology SARS-CoV-2 Vaccination Study Group. COVID-19 Vaccine-Associated Cerebral Venous Thrombosis in Germany. Ann Neurol 90: 627-639. DOI: 10.1002/ana.26172.
Go to original source...
Go to PubMed...
- Steadman E, Fandaros M, Yin W (2021). SARS-CoV-2 and Plasma Hypercoagulability. Cell Mol Bioeng 14: 513-522. DOI: 10.1007/s12195-021-00685-w.
Go to original source...
Go to PubMed...
- Thiele T, Weisser K, Schönborn L, Funk MB, Weber G, Greinacher A, et al. (2022). Laboratory confirmed vaccine-induced immune thrombotic thrombocytopenia: Retrospective analysis of reported cases after vaccination with ChAdOx-1 nCoV-19 in Germany. Lancet Reg Health Eur 12: 100270. DOI: 10.1016/j.lanepe.2021.100270.
Go to original source...
Go to PubMed...
- Zakaria Z, Sapiai NA, Ghani ARI (2021). Cerebral venous sinus thrombosis 2 weeks after the first dose of mRNA SARS-CoV-2 vaccine. Acta Neurochir (Wien) 163: 2359-2362. DOI: 10.1007/s00701-021-04860-w.
Go to original source...
Go to PubMed...
- Zamboni P, Scerrati A, Sessa F, Pomara C, Mannucci PM (2022). Vaccine-induced immune thrombotic thrombocytopenia with atypical vein thrombosis: Implications for clinical practice. Phlebology 37: 180-187. DOI: 10.1177/02683555211068948.
Go to original source...
Go to PubMed...
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