Evidence map›Paper›PMID 35218512›Full record

ArticleInfection2022

Hemophagocytic lymphohistiocytosis after SARS-CoV-2 vaccination.

Marie-Lisa Hieber, Rosanne Sprute, Dennis A Eichenauer, Michael Hallek, Ron D Jachimowicz

Open access · hybridAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Infection, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
4.0field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 27 citations in OpenAlex.

  1. Pooled it
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  6. Iatrogenic HLH.Advances in experimental medicine and biology · 2024
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Marie-Lisa Hieber *Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne and Duesseldorf, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Rosanne Sprute *Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne and Duesseldorf, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.ORCID http://orcid.org/0000-0003-2457-6437
Dennis A EichenauerDepartment I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne and Duesseldorf, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.ORCID http://orcid.org/0000-0002-1927-3514
Michael HallekDepartment I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne and Duesseldorf, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany.
Ron D JachimowiczDepartment I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne and Duesseldorf, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany. ron.jachimowicz@uk-koeln.de.ORCID http://orcid.org/0000-0001-9522-7061
University of Cologne · DETH Köln - University of Applied Sciences · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe coronavirus disease 2019 (COVID-19) pandemic has led to the approval of novel vaccines with different mechanisms of action. Until now, more than 4.7 billion persons have been vaccinated around the world, and adverse effects not observed in pre-authorization trials are being reported at low frequency.

methodsWe report a case of severe hemophagocytic lymphohistiocytosis (HLH) after SARS-CoV-2 immunization and performed a literature search for all reported cases of COVID-19 vaccine-associated HLH.

resultsA 24-year-old female developed HLH after immunization with the mRNA COVID-19 vaccine Comirnaty. Diagnosis was made according to HLH-2004 criteria; the HScore was 259 (> 99% HLH probability) with maximum ferritin of 138.244 µg/L. The patient was initially treated with intravenous immunoglobulins (IVIGs) and dexamethasone without response. The addition of the human interleukin 1 receptor antagonist Anakinra resulted in full recovery within 6 weeks after vaccination. A literature search revealed 15 additional cases of HLH after SARS-CoV-2 vaccination, the majority after immunization with Comirnaty (n = 7) or the viral vector vaccine Vaxzevria (n = 6). Treatment modalities included corticosteroids (n = 13), Anakinra (n = 5), IVIGs (n = 5), and etoposide (n = 2). Eight patients underwent combination treatment. Three of 16 patients died.

conclusionCOVID-19 vaccines may occasionally trigger HLH, and Anakinra may be an efficacious treatment option for this condition.

Indexed as

COVID-19COVID-19 VaccinesLymphohistiocytosis, HemophagocyticAdrenal Cortex HormonesAdultDexamethasoneEtoposideFemaleFerritinsHumansImmunoglobulins, IntravenousInterleukin 1 Receptor Antagonist ProteinReceptors, Interleukin-1RNA, MessengerSARS-CoV-2VaccinationAdrenal Cortex HormonesCOVID-19 VaccinesDexamethasoneEtoposideFerritinsImmunoglobulins, IntravenousInterleukin 1 Receptor Antagonist ProteinReceptors, Interleukin-1RNA, MessengerHyperferritinemiaHyperinflammationKineretLymphadenopathyMacrophage activation syndromeSARS-CoV-2 vaccine

Identifiers

PMID35218512
PMCPMC8881936
OpenAlexW4214603323

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.