ArticleBlood2021
Prothrombotic immune thrombocytopenia after COVID-19 vaccination.
Article in Blood, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 116 papers, 13 of them syntheses that pooled it.
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Who cites it
116 citing papers in PubMed, 13 syntheses or guidelines pooled it, 176 citations in OpenAlex.
- SARS-CoV-2 pathophysiology and post-vaccination severity: a systematic review.Immunologic research · 2024Pooled it
- A systemic review and recommendation for an autopsy approach to death followed the COVID 19 vaccination.Forensic science international · 2022Pooled it
- New-onset and relapsed liver diseases following COVID-19 vaccination: a systematic review.BMC gastroenterology · 2022Pooled it
- Acute ischemic stroke and vaccine-induced immune thrombotic thrombocytopenia post COVID-19 vaccination; a systematic review.Journal of the neurological sciences · 2022Pooled it
- Meaningful use of imaging resources to rule out cerebral venous sinus thrombosis after ChAdOx1 COVID-19 vaccination: Evaluation of the AHA diagnostic algorithm with a clinical cohort and a systematic data review.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2022Pooled it
- Thromboembolism after COVID-19 Vaccination: A Systematic Review of Such Events in 286 Patients.Annals of vascular surgery · 2022Pooled it
- Thrombosis patterns and clinical outcome of COVID-19 vaccine-induced immune thrombotic thrombocytopenia: A Systematic Review and Meta-Analysis.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Pooled it
- A systematic review of vaccine-induced thrombotic thrombocytopenia in individuals who received COVID-19 adenoviral-vector-based vaccines.Journal of thrombosis and thrombolysis · 2022Pooled it
- Cardiovascular and haematological events post COVID-19 vaccination: A systematic review.Journal of cellular and molecular medicine · 2022Pooled it
- Ischemic Stroke and Vaccine-Induced Immune Thrombotic Thrombocytopenia following COVID-19 Vaccine: A Case Report with Systematic Review of the Literature.Cerebrovascular diseases (Basel, Switzerland) · 2022Pooled it
- COVID-19 Vaccine-Related Thrombosis: A Systematic Review and Exploratory Analysis.Frontiers in immunology · 2021Pooled it
- Thrombosis with Thrombocytopenia Syndrome After Administration of AZD1222 or Ad26.COV2.S Vaccine for COVID-19: A Systematic Review.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Guideline
- Platelets link coagulation and complement in regulating murine placental vascular development.The Journal of clinical investigation · 2026Article
- A case of immune thrombocytopenia complicated by catastrophic antiphospholipid antibody syndrome and subsequent intramuscular haemorrhage.Journal of medical case reports · 2026Article
- Hematologic and coagulation responses to Johnson & Johnson COVID-19 vaccination in the Amhara region, Ethiopia.Scientific reports · 2026Article
- Immobilized IgG-containing immune complexes require platelets to recruit neutrophils during inflammation.The Journal of clinical investigation · 2026Article
- Unique Features and Collateral Immune Effects of mRNA-LNP COVID-19 Vaccines: Plausible Mechanisms of Adverse Events and Complications.Pharmaceutics · 2025Review
- COVID-19 and acute limb ischemia: latest hypotheses of pathophysiology and molecular mechanisms.Journal of Zhejiang University. Science. B · 2025Review
- COVID-19 vaccine-induced immune thrombotic thrombocytopenia: pathophysiology and diagnosis.Annals of hematology · 2025Review
56 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We report 5 cases of prothrombotic immune thrombocytopenia after exposure to the ChAdOx1 vaccine (AZD1222, Vaxzevria) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients presented 5 to 11 days after first vaccination. The spectrum of clinical manifestations included cerebral venous sinus thrombosis, splanchnic vein thrombosis, arterial cerebral thromboembolism, and thrombotic microangiopathy. All patients had thrombocytopenia and markedly elevated D-dimer. Autoantibodies against platelet factor 4 (PF4) were detected in all patients, although they had never been exposed to heparin. Immunoglobulin from patient sera bound to healthy donor platelets in an AZD1222-dependent manner, suppressed by heparin. Aggregation of healthy donor platelets by patient sera was demonstrated in the presence of buffer or AZD1222 and was also suppressed by heparin. Anticoagulation alone or in combination with eculizumab or intravenous immunoglobulin (IVIG) resolved the pathology in 3 patients. Two patients had thromboembolic events despite anticoagulation at a time when platelets were increasing after IVIG. In summary, an unexpected autoimmune prothrombotic disorder is described after vaccination with AZD1222. It is characterized by thrombocytopenia and anti-PF4 antibodies binding to platelets in AZD1222-dependent manner. Initial clinical experience suggests a risk of unusual and severe thromboembolic events.
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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.