Aplastic Anemia Following COVID-19 Vaccination: A Systematic Review of Case Reports and Case Series

Nelson Luis Cahuapaza-Gutierrez, Tsuriel Sofía Campos-Escalante
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Abstract

Aplastic anemia (AA) is the prototypical bone marrow failure syndrome due to the destruction of hematopoietic stem cells by cytotoxic T cells. According to case reports, vaccines could lead to the development of AA. We conducted the present systematic review to evaluate cases of AA following vaccination against coronavirus disease (COVID-19). We searched the following databases: PubMed, Scopus, and EMBASE in English, Portuguese, and Spanish languages until April 24, 2023. Published reports and case series on the occurrence of AA following vaccination against COVID-19 were included. The Joanna Brigs Institute was used to assess study quality and risk of bias. Six studies were selected from 102 research studies and data were extracted according to the inclusion criteria. All case reports and case series reported the occurrence of AA following COVID-19 vaccination. AA events were mainly observed in vaccines with messenger ribonucleic acid technology (Moderna; Pfizer-BioNTech). AA was diagnosed by bone marrow biopsy and severity was determined by Camitta criteria. All cases of AA were properly diagnosed. The sample size was small; therefore, further investigations are required to demonstrate and elucidate the complete pathophysiological mechanisms of AA development after receiving COVID-19 vaccination.
接种 COVID-19 疫苗后出现再生障碍性贫血:病例报告和病例系列的系统回顾
再生障碍性贫血(AA)是由于细胞毒性 T 细胞破坏造血干细胞而导致的典型骨髓衰竭综合征。根据病例报告,疫苗可能导致再生障碍性贫血的发生。我们进行了本系统综述,以评估接种冠状病毒病(COVID-19)疫苗后出现 AA 的病例。我们检索了以下数据库:PubMed、Scopus 和 EMBASE(英文、葡萄牙文和西班牙文),检索时间截至 2023 年 4 月 24 日。纳入了有关接种 COVID-19 疫苗后发生 AA 的已发表报告和系列病例。乔安娜-布里格斯研究所(Joanna Brigs Institute)用于评估研究质量和偏倚风险。从 102 项研究中筛选出 6 项研究,并根据纳入标准提取了数据。所有病例报告和系列病例都报告了接种 COVID-19 疫苗后发生 AA 的情况。AA事件主要出现在采用信使核糖核酸技术(Moderna;辉瑞生物技术公司)的疫苗中。AA通过骨髓活检确诊,严重程度根据卡米塔标准确定。所有 AA 病例均得到正确诊断。由于样本量较小,因此还需要进一步的研究来证明和阐明接种 COVID-19 疫苗后 AA 发病的完整病理生理机制。
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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