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ABO blood group associated with cerebral venous thrombosis after Oxford-AstraZeneca COVID-19 vaccination: a
Gie Ken-Dror1, Pankaj Sharma1,2,
1Institute of Cardiovascular Research Royal Holloway, University of London (ICR2UL), London TW20 0EX, UK.
Insights
Individuals with blood group O have a higher risk of developing vaccine-induced thrombotic thrombocytopenia (VITT-CVT) after the AstraZeneca COVID-19 vaccine. This finding suggests blood type may influence vaccine safety for cerebral venous thrombosis (CVT).
Area of Science:
- Immunology
- Hematology
- Vaccinology
Background:
- Cerebral venous thrombosis (CVT) is a rare but serious condition.
- The AstraZeneca ChAdOx1-S vaccine has been associated with vaccine-induced thrombotic thrombocytopenia (VITT).
- The role of blood group in VITT-CVT development requires further investigation.
Purpose of the Study:
- To investigate the association between ABO blood groups and the risk of developing CVT after the AstraZeneca COVID-19 vaccination.
- To determine if blood type is an independent risk factor for VITT-CVT.
Main Methods:
- A case-control study was conducted.
- Logistic regression analysis was used to compare blood group frequencies between vaccinated and unvaccinated CVT patients.
- Patients were matched for age and sex.
Main Results:
- Blood group O was significantly more prevalent in patients who developed VITT-CVT after ChAdOx1-S vaccination compared to unvaccinated controls (43% vs. 17%).
- Blood group A was less prevalent in the vaccinated group compared to unvaccinated controls (47% vs. 71%).
- No significant blood group differences were found in non-ChAdOx1-S vaccine VITT-CVT or pre-COVID-19 CVT groups.
Conclusions:
- Blood group O is associated with an increased risk of VITT-CVT following ChAdOx1-S vaccination, independent of other risk factors.
- Further research with larger datasets is needed to assess the safety of ChAdOx1-S vaccination for individuals with blood groups B and AB.
Objectives:
To determine whether blood group influences development of cerebral venous thrombosis (CVT) after administration of the coronavirus disease 2019 (COVID-19) AstraZeneca ChAdOx1-S vaccine.
Design:
A case-control study. Univariate and multivariate logistic regression was used to determine the association between blood type and COVID-19 vaccination status.
Setting:
Vaccinated and unvaccinated patients recruited from the international Bio-Repository to Establish the Aetiology of Sinovenous Thrombosis study and the Cerebral Venous Sinus Thrombosis With Thrombocytopenia Syndrome Study Group.
Participants:
All patients were of European descent and age and sex matched. Cases (n = 82) were patients ≥18 years old who suffered a CVT within 28 days of a first dose of ChAdOx1-S vaccine. Controls (n = 441) were unvaccinated CVT patients ≥18 years old. All patients were of European descent.
Main Outcome Measures:
Frequency of blood type and ABO allele distribution by vaccination status.
Results:
Blood group O was found to be more prevalent among CVT patients with vaccine-induced thrombotic thrombocytopenia (VITT-CVT) after ChAdOx1-S vaccination compared with unvaccinated CVT cases (43% vs. 17%, respectively, p < 0.001). Blood group A was less prevalent, though still high, in the vaccinated group compared with the unvaccinated group (47% vs. 71%, respectively, p < 0.001). No significant differences were observed in the VITT-CVT non-ChAdOx1-S vaccine group and unvaccinated pre-COVID-19 CVT group for blood group.
Conclusions:
Blood group O is more prevalent among patients with VITT-CVT after ChAdOx1-S vaccination compared with unvaccinated cases, independent of well-established CVT risk factors. A larger dataset may be able to determine whether those of blood groups B and/or AB may be safely vaccinated with the low cost, readily available and easily transported ChAdOx1-S rather than adopting a complete ban.
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