A Rare Case of Cerebral Venous Thrombosis and Disseminated Intravascular Coagulation Temporally Associated to the COVID-19 Vaccine Administration.
A Rare Case of Cerebral Venous Thrombosis and Disseminated Intravascular Coagulation Temporally Associated to the COVID-19 Vaccine Administration.
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DOI：
10.3390/jpm11040285
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发表时间：
2021-04-08
影响因子：
--
通讯作者：
Grassi R
中科院分区：
文献类型：
--
作者：
D'Agostino V;Caranci F;Negro A;Piscitelli V;Tuccillo B;Fasano F;Sirabella G;Marano I;Granata V;Grassi R;Pupo D;Grassi R
在撰写本报告时(2021年3月20日)，在全球范围内，已向世卫组织报告了121.759.109例新冠肺炎确诊病例，包括2.690.731例死亡。在全球范围内，截至2021年3月18日，共接种了364.184.603剂疫苗。在意大利，已向世卫组织报告了3306.711例新冠肺炎确诊病例，其中103.855人死亡。在意大利，2021年3月9日共接种了6.634.450剂疫苗。2021年3月15日，意大利药品管理局决定，作为预防措施，在全国范围内暂停阿斯利康新冠肺炎疫苗的使用，等待欧洲药品管理局的裁决。由于接种疫苗的人死亡，这一决定与其他欧洲国家采取的类似措施一致。2021年3月18日，EMA的安全委员会在其特别会议上结束了对接种新冠肺炎疫苗阿斯利康疫苗的人的血栓栓塞事件的初步审查，证实该疫苗的好处仍然大于副作用的风险，然而，该疫苗可能与非常罕见的与血小板减少症相关的血栓病例有关，即血小板水平低并或不伴有出血，包括罕见的脑静脉血栓形成。我们报告一位54岁女性在注射阿斯利康新冠肺炎疫苗12天后出现弥散性血管内凝血并多区血栓形成的病例。脑部计算机断层扫描显示非典型部位有多个亚急性轴内出血，包括右额叶和颞叶。采用普通球囊右冠状动脉成形术(POBA)，不植入支架，恢复远端血流，但持续广泛的血管血栓形成。连续的胸部血管CT显示多个充盈缺损区合并多支血管受累：左上叶节段支、左叶间动脉、右中叶节段支和右叶间动脉水平。同一天的脑磁共振成像(MRI)显示存在与上矢状窦血栓相关的急性基底动脉血栓形成。腹部血管CT显示左门静脉分支水平和右肝上静脉水平的充盈缺损区。双侧，肾上腺出血和盆腔出血。对凝血因子的评估没有显示出基因变化，因此鼻咽拭子排除了新冠肺炎感染的可能性。患者在重症监护病房住院5天后死亡。
Globally, at the time of writing (20 March 2021), 121.759.109 confirmed COVID-19 cases have been reported to the WHO, including 2.690.731 deaths. Globally, on 18 March 2021, a total of 364.184.603 vaccine doses have been administered. In Italy, 3.306.711 confirmed COVID-19 cases with 103.855 deaths have been reported to WHO. In Italy, on 9 March 2021, a total of 6.634.450 vaccine doses have been administered. On 15 March 2021, Italian Medicines Agency (AIFA) decided to temporarily suspend the use of the AstraZeneca COVID-19 vaccine throughout the country as a precaution, pending the rulings of the European Medicines Agency (EMA). This decision was taken in line with similar measures adopted by other European countries due to the death of vaccinated people. On 18 March 2021, EMA’s safety committee concluded its preliminary review about thromboembolic events in people vaccinated with COVID-19 Vaccine AstraZeneca at its extraordinary meeting, confirming the benefits of the vaccine continue to outweigh the risk of side effects, however, the vaccine may be associated with very rare cases of blood clots associated with thrombocytopenia, i.e., low levels of blood platelets with or without bleeding, including rare cases of cerebral venous thrombosis (CVT). We report the case of a 54-year-old woman who developed disseminated intravascular coagulation (DIC) with multi-district thrombosis 12 days after the AstraZeneca COVID-19 vaccine administration. A brain computed tomography (CT) scan showed multiple subacute intra-axial hemorrhages in atypical locations, including the right frontal and the temporal lobes. A plain old balloon angioplasty (POBA) of the right coronary artery was performed, without stent implantation, with restoration of distal flow, but with persistence of extensive thrombosis of the vessel. A successive thorax angio-CT added the findings of multiple contrast filling defects with multi-vessel involvement: at the level of the left upper lobe segmental branches, of left interlobar artery, of the right middle lobe segmental branches and of the right interlobar artery. A brain magnetic resonance imaging (MRI) in the same day showed the presence of an acute basilar thrombosis associated with the superior sagittal sinus thrombosis. An abdomen angio-CT showed filling defects at the level of left portal branch and at the level of right suprahepatic vein. Bilaterally, it was adrenal hemorrhage and blood in the pelvis. An evaluation of coagulation factors did not show genetic alterations so as the nasopharyngeal swab ruled out a COVID-19 infection. The patient died after 5 days of hospitalization in intensive care.
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DOI：
10.1016/s0140-6736(20)32661-1
发表时间：
2021-01-09
期刊：
Lancet (London, England)
影响因子：
--
作者：
Voysey M;Clemens SAC;Madhi SA;Weckx LY;Folegatti PM;Aley PK;Angus B;Baillie VL;Barnabas SL;Bhorat QE;Bibi S;Briner C;Cicconi P;Collins AM;Colin-Jones R;Cutland CL;Darton TC;Dheda K;Duncan CJA;Emary KRW;Ewer KJ;Fairlie L;Faust SN;Feng S;Ferreira DM;Finn A;Goodman AL;Green CM;Green CA;Heath PT;Hill C;Hill H;Hirsch I;Hodgson SHC;Izu A;Jackson S;Jenkin D;Joe CCD;Kerridge S;Koen A;Kwatra G;Lazarus R;Lawrie AM;Lelliott A;Libri V;Lillie PJ;Mallory R;Mendes AVA;Milan EP;Minassian AM;McGregor A;Morrison H;Mujadidi YF;Nana A;O'Reilly PJ;Padayachee SD;Pittella A;Plested E;Pollock KM;Ramasamy MN;Rhead S;Schwarzbold AV;Singh N;Smith A;Song R;Snape MD;Sprinz E;Sutherland RK;Tarrant R;Thomson EC;Török ME;Toshner M;Turner DPJ;Vekemans J;Villafana TL;Watson MEE;Williams CJ;Douglas AD;Hill AVS;Lambe T;Gilbert SC;Pollard AJ;Oxford COVID Vaccine Trial Group
通讯作者：
Oxford COVID Vaccine Trial Group
意大利 2019 年冠状病毒病 (COVID-19)：胸部 CT 检查的双重解读。
影响因子：
4.2
作者：
Reginelli A;Grassi R;Feragalli B;Belfiore MP;Montanelli A;Patelli G;La Porta M;Urraro F;Fusco R;Granata V;Petrillo A;Giacobbe G;Russo GM;Sacco P;Grassi R;Cappabianca S
通讯作者：
Cappabianca S
BNT162B2 mRNA COVID-19疫苗的安全性和功效。
DOI：
10.1056/nejmoa2034577
发表时间：
2020-12-31
期刊：
The New England journal of medicine
影响因子：
--
作者：
Polack FP;Thomas SJ;Kitchin N;Absalon J;Gurtman A;Lockhart S;Perez JL;Pérez Marc G;Moreira ED;Zerbini C;Bailey R;Swanson KA;Roychoudhury S;Koury K;Li P;Kalina WV;Cooper D;Frenck RW Jr;Hammitt LL;Türeci Ö;Nell H;Schaefer A;Ünal S;Tresnan DB;Mather S;Dormitzer PR;Şahin U;Jansen KU;Gruber WC;C4591001 Clinical Trial Group
通讯作者：
C4591001 Clinical Trial Group
影响因子：
8.9
作者：
Borghesi, Andrea;Maroldi, Roberto
通讯作者：
Maroldi, Roberto
影响因子：
39
作者：
Wu, Chaomin;Chen, Xiaoyan;Song, Yuanlin
通讯作者：
Song, Yuanlin