Trombosis venosa cerebral después de la vacunación contra la COVID-19 en el Reino Unido: un estudio de cohorte multicéntrico
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Updated: Oct 25, 2025
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A Multicenter MRI Protocol for the Evaluation and Quantification of Deep Vein Thrombosis
Published on: June 2, 2015
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Richard J Perry1, Arina Tamborska2, Bhagteshwar Singh3
1Comprehensive Stroke Service, National Hospital for Neurology and Neurosurgery, UCL Hospitals NHS Foundation Trust, London, UK; Stroke Research Centre, UCL Queen Square Institute of Neurology, London, UK.
Lancet (London, England)
|August 9, 2021
Resumen
La trombocitopenia inmune trombótica inducida por la vacuna (VITT, por sus siglas en inglés) causa una trombosis venosa cerebral grave. El tratamiento precoz con anticoagulantes no heparínicos y inmunoglobulinas puede mejorar los resultados en pacientes con VITT.
Área de la Ciencia:
- Neurología
- Inmunología
- Hematología
Sus antecedentes:
- La trombocitopenia inmune trombótica inducida por la vacuna (VITT) es un efecto secundario raro pero grave de la vacunación contra la COVID-19.
- La trombosis venosa cerebral (TVC) es la manifestación más común del VITT.
- Se necesita una caracterización detallada de la CVT en pacientes con VITT y una comparación con los casos de CVT sin VITT.
Objetivo del estudio:
- Documentar las características clínicas y radiológicas de la CVT posterior a la vacunación.
- Comparar los resultados entre la FPC asociada al VITT y la FPC no asociada al VITT.
- Evaluar el impacto de tratamientos específicos en los resultados del VITT.
Principales métodos:
- Estudio de cohorte multicéntrico de pacientes con CVT después de la vacunación contra COVID-19.
- La recolección de datos incluyó hallazgos clínicos, de laboratorio (incluidos los anticuerpos anti-PF4) y radiológicos.
- Casos de VITT definidos por un bajo recuento de plaquetas y un aumento del D-dimero; los resultados se evaluaron utilizando el puntaje de Rankin modificado.
Principales resultados:
- La CVT asociada a VITT se produjo en 70 de 95 pacientes, predominantemente en individuos más jóvenes.
- Los pacientes con VITT experimentaron una trombosis más extensa y tasas más altas de muerte o dependencia (47%) en comparación con los pacientes sin VITT (16%).
- Los anticoagulantes no heparínicos y el tratamiento intravenoso con inmunoglobulinas se asociaron con mejores resultados en pacientes con VITT.
Conclusiones:
- La CVT asociada a VITT es una afección grave con peores resultados en comparación con la CVT no asociada a VITT.
- Los anticoagulantes no heparínicos y la terapia con inmunoglobulinas son prometedores para mejorar los resultados de VITT.
- Se proponen criterios de diagnóstico revisados para la CVT asociada a VITT para incluir a más pacientes.
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