在COVID-19疫苗接种后出现或没有发生血栓塞的血栓细胞减少:长期管理
1Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
Research and practice in thrombosis and haemostasis
|March 29, 2024
概括
COVID-19疫苗的不良事件,包括疫苗诱导的血小板缩和血栓形成 (VITT) 和免疫血小板缩,需要长期管理. 治疗策略有所不同,一些VITT患者需要长时间的抗凝剂和血交换.
科学领域:
- 血液学 血液学 血液学
- 免疫学 免疫学 免疫学
- 疫苗学 疫苗学 疫苗学
背景情况:
- 越来越多的证据将COVID-19疫苗接种与血栓和血栓细胞缩事件联系在一起.
- 有限的数据存在于这些疫苗接种后血液学不良事件的长期管理.
研究的目的:
- 描述COVID-19疫苗接种后患有血小板缺血的患者的表现,管理和结果.
- 分析疫苗诱导的血小板缩和血栓形成 (VITT) 与免疫血小板缩之间的治疗反应.
主要方法:
- 对于在COVID-19疫苗接种后出现新发性血小板狭窄症的成年患者 (>18岁) 的回顾性图表审查.
- 对出现症状,实验室发现和治疗反应的分析.
主要成果:
- 确定了四名被诊断为VITT的患者和五名免疫血小板缩的患者.
- VITT患者接受了包括静脉注射免疫球蛋白,皮质类固醇和血交换在内的治疗,有些人需要9个月的抗凝药.
- 免疫性血栓塞缩症患者对静脉注射免疫球蛋白和皮质类固醇反应良好.
结论:
- 对于COVID-19疫苗后的血小板衰竭存在有效的管理策略,包括VITT和免疫血小板衰竭.
- 患有VITT的患者可能需要延长抗凝剂和密集治疗.
- 随后的mRNA疫苗接种在这个队列中没有造成不良的血液学影响.
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