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. 2022 Jul 31;10(8):1226.
doi: 10.3390/vaccines10081226.

Association of COVID-19 Vaccines ChAdOx1-S and BNT162b2 with Circulating Levels of Coagulation Factors and Antithrombin

Amal Hasan  1 , Hossein Arefanian  1 , Arshad Mohamed Channanath  2 , Irina AlKhairi  3 , Preethi Cherian  3 , Sriraman Devarajan  4 , Thangavel Alphonse Thanaraj  2 , Mohamed Abu-Farha  4 , Jehad Abubaker  3 , Fahd Al-Mulla  2
Affiliations

Association of COVID-19 Vaccines ChAdOx1-S and BNT162b2 with Circulating Levels of Coagulation Factors and Antithrombin

Amal Hasan et al. Vaccines (Basel). .

Abstract

Background: Severe coronavirus disease 2019 (COVID-19) is associated with increased risk of thrombosis and thromboembolism. Exposure to COVID-19 vaccines is also associated with immune thrombotic thrombocytopenia, ischemic stroke, intracerebral haemorrhage, and cerebral venous thrombosis, and it is linked with systemic activation of coagulation.

Methods: We assess the circulating levels of coagulation factors (factors XI, XII, XIII, and prothrombin) and antithrombin in individuals who completed two doses of either ChAdOx1-S or BNT162b2 COVID-19 vaccine, within the timeframe of two months, who had no previous history of COVID-19.

Results: Elevated levels of factors XI, XII, XIII, prothrombin, and antithrombin were seen compared to unvaccinated controls. Levels of coagulation factors, antithrombin, and prothrombin to antithrombin ratio were higher with BNT162b2 compared to ChAdOx1-S vaccine.

Conclusions: The clinical significance of such coagulation homeostasis disruption remains to be elucidated but it is worthy of global scientific follow-up effort.

Keywords: COVID-19 vaccines; antithrombin; coagulation factors.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Circulating levels of coagulation factors and antithrombin after COVID-19 vaccinations. The figure shows the circulating levels of coagulation factors (XI, XII, XIII, and prothrombin) and antithrombin in the timeframe of two months since each group completed two doses of either the ChAdOx1-S (1–57 days post dose 2 with a median of 16 days (IQR: 8, 29); n = 166) or the BNT162b2 (1–44 days post dose 2 with a median of 27 days (IQR: 18, 36); n = 103) vaccine compared to a non-vaccinated group (n = 34). Statistical analysis was conducted using R Core Team (2021) software. Values are log transformed to reduce skewness. Continuous values were compared using the Wilcoxon rank sum test.
Figure 2
Figure 2
Correlation of circulating levels of coagulation factors/antithrombin with the duration (in days) between the administration of the 2nd dose of either the ChAdOx1-S or BNT162b2 vaccine and sample collection (ChAdOx1-S vaccine: 1–57 days post dose 2 with a median of 16 days (IQR: 8, 29), n = 166; BNT162b2 vaccine: 1–44 days post dose 2 with a median of 27 days (IQR: 18, 36), n = 103). The non-parametric Spearman’s r test was used for correlation analysis.
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