Síndrome de trombosis con trombocitopenia asociado a vacunas de adenovirus frente a la COVID-19: Epidemiología y presentación clínica de la serie española

IF 2.9 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia Pub Date : 2024-11-01 DOI:10.1016/j.nrl.2022.04.010

D. García-Azorín , E. Lázaro , D. Ezpeleta , R. Lecumberri , R. de la Cámara , M. Castellanos , C. Iñiguez Martínez , L. Quiroga-González , G. Elizondo Rivas , A. Sancho-López , P. Rayón Iglesias , E. Segovia , C. Mejías , D. Montero Corominas

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引用次数: 0

Abstract

Background

We describe the epidemiological and clinical characteristics of thrombosis with thrombocytopenia syndrome (TTS) cases reported in Spain.

Methods

We included all venous or arterial thrombosis with thrombocytopenia following adenovirus vector-based vaccines (AstraZeneca or Janssen) to prevent COVID-19 disease between February 1^st and September 26^th, 2021. We describe the crude rate and the standardized morbidity ratio. We assessed the predictors of mortality.

Results

Sixty-one cases were reported and 45 fulfilled eligibility criteria, 82% women. The crude TTS rate was 4/1,000,000 doses and 14-15/1,000,000 doses between 30-49 years. The number of observed cases of cerebral venous thrombosis was 6-18 higher than the expected in patients younger than 49 years. Symptoms started 10 (interquartile range [IQR]: 7-14) days after vaccination. Eighty percent (95% confidence interval [CI]: 65-90%) had thrombocytopenia at the time of the emergency department visit, and 65% (95% CI: 49-78%) had D-dimer >2,000 ng/mL. Patients had multiple location thrombosis in 36% and fatal outcome in 24% cases. A platelet nadir < 50,000/μL (odds ratio [OR]: 7.4; CI 95%: 1.2-47.5) and intracranial hemorrhage (OR: 7.9; IC 95%: 1.3-47.0) were associated with fatal outcome.

Conclusion

TTS must be suspected in patients with symptoms 10 days after vaccination and thrombocytopenia and/or D-dimer increase.

Abstract Image

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[预防 COVID-19 的腺病毒载体疫苗接种后血栓形成伴血小板减少综合征：西班牙的流行病学和临床表现]。

背景：我们描述了西班牙报告的血栓伴血小板减少综合征（TTS）病例的流行病学和临床特征：我们描述了西班牙报告的血栓伴血小板减少综合征（TTS）病例的流行病学和临床特征：我们纳入了 2021 年 2 月 1 日至 9 月 26 日期间接种腺病毒载体疫苗（阿斯利康或杨森）以预防 COVID-19 疾病的所有伴血小板减少的静脉或动脉血栓形成病例。我们描述了粗死亡率和标准化发病率。我们评估了死亡率的预测因素：共报告了 61 例病例，其中 45 例符合资格标准，82% 为女性。粗TTS率为4/1,000,000剂量，30-49岁为14-15/1,000,000剂量。在 49 岁以下的患者中，观察到的脑静脉血栓病例数比预期高出 6-18 例。症状开始于接种疫苗后 10 天（四分位距（IQR）：7-14 天）。80%（95% 置信区间 (CI)：65-90%）的患者在急诊就诊时血小板减少，65%（95% 置信区间 (CI)：49-78%）的患者 D-二聚体大于 2000 纳克/毫升。36%的患者有多处血栓形成，24%的患者有致命后果。血小板最低点接种疫苗 10 天后出现症状、血小板减少和/或 D-二聚体增加的患者必须怀疑 TTS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurologia 医学-临床神经学

CiteScore

5.90

自引率

2.60%

发文量

135

审稿时长

48 days

期刊介绍： Neurología es la revista oficial de la Sociedad Española de Neurología y publica, desde 1986 contribuciones científicas en el campo de la neurología clínica y experimental. Los contenidos de Neurología abarcan desde la neuroepidemiología, la clínica neurológica, la gestión y asistencia neurológica y la terapéutica, a la investigación básica en neurociencias aplicada a la neurología. Las áreas temáticas de la revistas incluyen la neurologia infantil, la neuropsicología, la neurorehabilitación y la neurogeriatría. Los artículos publicados en Neurología siguen un proceso de revisión por doble ciego a fin de que los trabajos sean seleccionados atendiendo a su calidad, originalidad e interés y así estén sometidos a un proceso de mejora. El formato de artículos incluye Editoriales, Originales, Revisiones y Cartas al Editor, Neurología es el vehículo de información científica de reconocida calidad en profesionales interesados en la neurología que utilizan el español, como demuestra su inclusión en los más prestigiosos y selectivos índices bibliográficos del mundo.