ReviewThe American journal of emergency medicine2021
Thrombosis with thrombocytopenia syndrome associated with COVID-19 vaccines.
Review in The American journal of emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 5 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
57 citing papers in PubMed, 5 syntheses or guidelines pooled it, 101 citations in OpenAlex.
- Pooled it
- Thromboembolism after COVID-19 Vaccination: A Systematic Review of Such Events in 286 Patients.Annals of vascular surgery · 2022Pooled it
- Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis.The Lancet. Respiratory medicine · 2022Pooled it
- Guidelines on COVID-19 vaccination in patients with immune-mediated rheumatic diseases: a Brazilian Society of Rheumatology task force.Advances in rheumatology (London, England) · 2022Guideline
- COVID-19 Vaccine-Associated Thrombosis With Thrombocytopenia Syndrome (TTS): A Systematic Review and Post Hoc Analysis.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Hematologic and coagulation responses to Johnson & Johnson COVID-19 vaccination in the Amhara region, Ethiopia.Scientific reports · 2026Article
- Ophthalmic complications associated with COVID-19: a large US national database analysis.Eye (London, England) · 2025Article
- Article
- Cardiovascular Sequelae of the COVID-19 Vaccines.Cureus · 2025Review
- The Ambivalence of Post COVID-19 Vaccination Responses in Humans.Biomolecules · 2024Review
- Global Safety Assessment of Adverse Events of Special Interest Following 2 Years of Use and 772 Million Administered Doses of mRNA-1273.Open forum infectious diseases · 2024Article
- Superior mesenteric vein thrombosis due to COVID-19 vaccination: a case report.Journal of medical case reports · 2024Article
- Is influenza vaccination associated with nephrotic syndrome relapse in children? A multicenter prospective study.Pediatric nephrology (Berlin, Germany) · 2023Article
- Article
- Pulmonary Embolism after Vaccination with the COVID-19 Vaccine (Pfizer, BNT162b2): A Case Report.Vaccines · 2023Article
- Clinical Features of COVID-19 Vaccine-Associated Autoimmune Hepatitis: A Systematic Review.Diseases (Basel, Switzerland) · 2023Review
- Acute limb ischemia secondary to vaccine-induced thrombotic thrombocytopenia.Annals of vascular surgery. Brief reports and innovations · 2023Article
- An inactivated SARS-CoV-2 vaccine induced cross-neutralizing persisting antibodies and protected against challenge in small animals.iScience · 2023Article
- Article
- Map of thrombogenesis in viral infections and viral-driven tumours.Discover oncology · 2023Review
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrent vaccines for the Coronavirus Disease of 2019 (COVID-19) have demonstrated efficacy with low risk of adverse events. However, recent reports of thrombosis with thrombocytopenia syndrome (TTS) associated with adenovirus vector vaccines have raised concern.
objectiveThis narrative review summarizes the current background, evaluation, and management of TTS for emergency clinicians. DISCUSSION: TTS, also known as vaccine-induced immune thrombotic thrombocytopenia, is a reaction associated with exposure to the ChAdOx1 nCoV-19 (Oxford-AstraZeneca) and AD26.COV2·S (Johnson & Johnson) vaccine, which may result in thrombocytopenia and thrombotic events. There are several case series of patients diagnosed with TTS, but the overall incidence is rare. TTS is characterized by exposure to one of the aforementioned vaccines 4-30 days prior to presentation, followed by thrombosis, mild-to-severe thrombocytopenia, and a positive platelet factor-4 (PF4)-heparin enzyme-linked immunosorbent assay (ELISA). Thrombosis typically involves atypical locations, including cerebral venous thrombosis and splanchnic vein thrombosis. Evaluation should include complete blood count, peripheral smear, D-dimer, fibrinogen, coagulation panel, renal and liver function, and electrolytes, as well as PF4-heparin ELISA if available. Consultation with hematology is recommended if suspected or confirmed. Treatment may include intravenous immunoglobulin and anticoagulation, while avoiding heparin-based agents and platelet transfusion.
conclusionsWith increasing vaccine distribution, it is essential for emergency clinicians to be aware of the evaluation and management of this condition.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.