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[COVID-19, vaccines, and thrombotic events]

Maurizio Giuseppe Abrignani1, Adriano Murrone2, Leonardo De Luca3

  • 1U.O. Cardiologia, P.O. Sant'Antonio Abate, ASP Trapani, Erice (TP).

Giornale Italiano Di Cardiologia (2006)
|November 30, 2021
PubMed

Insights

COVID-19 infection and adenovirus-based vaccines can cause rare thrombotic events. Experts emphasize that the benefits of COVID-19 vaccination significantly outweigh the minimal risks of thrombosis.

Area of Science:

  • Cardiology
  • Immunology
  • Virology

Background:

  • COVID-19 is linked to cardiovascular complications, including thromboembolic events, potentially due to the viral spike protein.
  • Adenovirus-based vaccines, while crucial for prevention, have been associated with rare cases of vaccine-induced immune thrombotic thrombocytopenia (VITT).
  • VITT is characterized by thrombosis at unusual sites and thrombocytopenia, possibly due to anti-PF4 antibodies.

Purpose of the Study:

  • To review epidemiological data, clinical findings, and pathogenetic hypotheses of thrombosis associated with COVID-19 and its vaccines.
  • To provide cardiologists with evidence-based information for patient counseling.
  • To address patient concerns regarding cardiovascular risks of COVID-19 and vaccination.

Main Methods:

  • Comprehensive literature review of epidemiological studies.
  • Analysis of clinical data on thrombosis in COVID-19 patients and vaccine recipients.
  • Examination of pathogenetic hypotheses, including immunological mechanisms.

Main Results:

  • COVID-19 significantly increases the risk of venous and arterial thromboembolic events.
  • Vaccine-induced immune thrombotic thrombocytopenia is a rare but serious adverse event linked to adenovirus-based vaccines.
  • The risk of thrombosis from COVID-19 disease is substantially higher than the risk associated with vaccination.

Conclusions:

  • Cardiologists must be informed about the thrombotic risks of both COVID-19 and vaccines.
  • Patient counseling should emphasize that the benefits of vaccination outweigh the rare risks.
  • Further research into the mechanisms of VITT is warranted.

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