COVID-19 Vaccine-Induced Thrombotic Thrombocytopaenia With Venous and Arterial Thrombosis: A Case Report

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Zahid Khan1,2,3, George Besis3, Luciano Candilio3

  • 1Acute Medicine, Mid and South Essex NHS Foundation Trust, Southend on Sea, GBR.

Cureus
|October 3, 2022
PubMed

Insights

The COVID-19 vaccine, specifically Oxford-AstraZeneca, has been linked to rare cases of thrombosis. This case highlights a potential link between the vaccine and coronary artery thrombosis without thrombocytopenia.

Area of Science:

  • Cardiology
  • Immunology
  • Vaccinology

Background:

  • The COVID-19 pandemic has caused global health crises, necessitating widespread vaccination.
  • COVID-19 vaccines, including Oxford-AstraZeneca (AZD1222), have shown effectiveness but raised concerns about thrombosis.
  • COVID-19 itself is a prothrombotic state, often associated with venous thromboembolism.

Observation:

  • A 54-year-old patient presented with chest and abdominal pain 10 days after receiving the AstraZeneca COVID-19 vaccine.
  • Electrocardiogram revealed infero-lateral ST segment elevation, indicative of cardiac ischemia.
  • Coronary angiography showed a thrombotic occlusion in the right coronary artery (RCA).

Findings:

  • The patient experienced acute coronary syndrome potentially related to vaccine-induced prothrombotic effects.
  • Coronary angiography confirmed a high thrombotic burden in the RCA, with partial flow restoration after intervention.
  • This case suggests COVID-19 vaccines may induce thrombosis, even without thrombocytopenia.

Implications:

  • This case underscores the importance of considering vaccine-induced thrombosis in patients presenting with thrombotic events post-vaccination.
  • Further research is needed to elucidate the mechanisms of vaccine-induced thrombosis and its clinical spectrum.
  • Healthcare providers should remain vigilant for rare adverse events associated with COVID-19 vaccines.

Keywords:
acute myocardial infarcastra zeneca covid-19 vaccinecovid-19-associated acute coronary syndromecovid-19-induced thrombosistimi flowvaccine-induced thrombosis and thrombocytopenia (vitt)ventricular dysrhythmia

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