Figure - available from: American Journal of Hematology
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Rates of venous thromboembolism in patients with (solid line) and without (dotted line) thrombophilia.
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Patients with thrombophilia remain concerned about venous thromboembolism (VTE) risk with COVID‐19 vaccinations. The aim of this study was to examine VTE outcomes in patients with inherited or acquired thrombophilia who were vaccinated for COVID‐19. Vaccinated patients ≥18 years between November 1, 2020 and November 1, 2021 were analyzed using elec...
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Venous thromboembolism (VTE) is the third most common cause of death worldwide. The incidence of VTE varies according to different countries, ranging from 1–2 per 1000 person-years in Western Countries, while it is lower in Eastern Countries (<1 per 1000 person-years). Many risk factors have been identified in patients developing VTE, but the relat...
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... Where resources to perform these assays are unavailable, the diagnosis of VITT can be established based on a high degree of suspicion (eg, probable VITT), defined as a high D-dimer and thrombocytopenia (<150 000/μL) and thrombosis occurring 5-30 days after vaccination with adenoviral vector-based vaccine for COVID-19.Patients with a history of thromboembolism have been naturally concerned about the risk of recurrent thrombosis after vaccination. A large observational study in patients with a diagnosed thrombophilia defect did not show increased risk for thrombosis during 3 months after almost exclusive use of the messenger RNA vaccines[62].The treatment of VITT is complex, which makes the interpretation of studies that focus on a single agent challenging. Furthermore, as information about VITT rapidly accumulated, the diagnosis was made sooner, and the management of the disease changed. ...
... 15. For nonhospitalized patients with thrombophilia who receive a COVID-19 vaccine, prophylaxis with anticoagulants or an antiplatelet agent is not recommended for reducing risk of adverse outcomes[62]. ...
Although abundant data confirm the efficacy and safety profile of the developed vaccines against COVID-19, there are still some concerns regarding vaccination in high-risk populations. This is especially valid for patients susceptible to thrombotic or bleeding events and hesitant people due to the fear of thrombotic incidents following vaccination. This narrative review focuses on various inherited and acquired thrombotic and coagulation disorders and the possible pathophysiologic mechanisms interacting with the coagulation system during immunization in view of the currently available safety data regarding COVID-19 vaccines. Inherited blood coagulation disorders and inherited thrombotic disorders in the light of COVID-19, as well as blood coagulation and thrombotic disorders and bleeding complications following COVID-19 vaccines, along with the possible patho-genesis hypotheses, therapeutic interventions, and imaging for diagnosing are discussed in detail. Lastly, the lack of causality between the bleeding and thrombotic events and COVID-19 vaccines is debated, but still emphasizes the importance of vaccination against COVID-19, outweighing the minimal risk of potential rare adverse events associated with coagulation.
