COVID-19 vaccine-associated immune thrombosis and thrombocytopenia (VITT): Diagnostic and therapeutic recommendations for a new syndrome

Abstract

Very rare cases of thrombosis associated with thrombocytopenia have occurred following the vaccination with AstraZeneca COVID-19 vaccine. The aim of this concise review is to summarize the current knowledge on the epidemiologic and pathogenic mechanisms of this syndrome named vaccine-associated immune thrombosis and thrombocytopenia (VITT). A practical patient management section will also be dealt with using information available from national and international scientific societies as well as expert panels. A literature search on the VITT syndrome was carried out in PubMed using appropriate MeSH headings. Overall, 40 VITT cases have been reported. Continuous pharmacovigilance monitoring is needed to collect more data on the real incidence and the pathogenesis of VITT syndrome. Such information will also help us to optimize the management this rare but often clinically severe thrombotic condition associated with COVID-19 vaccination.

Keywords: AstraZeneca vaccine; cerebral venous thrombosis; heparin; thrombocytopenia.

FIGURE 1

Diagnostic algorithm of VITT syndrome. UFH, unfractionated heparin; LMWH: low molecular weight heparin; ELISA, enzyme‐linked immunosorbent assay; HIPA, heparin‐induced platelet activation assay; SRA, serotonin‐release assay