Evidence map›Paper›PMID 36403363›Full record

ArticleJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association2023

Vaccine associated benign headache and cutaneous hemorrhage after ChAdOx1 nCoV-19 vaccine: A cohort study.

Nina Haagenrud Schultz, Arne Vasli Lund Søraas, Ingvild Hausberg Sørvoll, Çigdem Akalin Akkök, Annette Vetlesen, Jagjit Singh Bhamra, Maria Therese Ahlen, Pål Andre Holme, Anne-Hege Aamodt, Karolina Skagen and 3 more

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PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 30% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 2 countries.

Nina Haagenrud SchultzDepartment of Haematology, Oslo University Hospital Rikshospitalet, Sognsveien 20, Oslo 0372, Norway; Department of Haematology, Akershus University Hospital, Sykehusveien 25, 1478 Nordbyhagen, Lørenskog, Norway. Electronic address: nischu@ous-hf.no.
Arne Vasli Lund SøraasDepartment of Microbiology, Oslo University Hospital Rikshospitalet, Sognsveien 20, Oslo 0372, Norway.
Ingvild Hausberg SørvollNorwegian National Unit for Platelet Immunology, Division of Diagnostics, University Hospital of North Norway, Sykehusveien 38, Tromsø 9019, Norway.
Çigdem Akalin AkkökDepartment of Immunology and Transfusion Medicine, Oslo University Hospital, Ullevål, Kirkeveien 166, Oslo 0450, Norway.
Annette VetlesenDepartment of Immunology and Transfusion Medicine, Oslo University Hospital, Ullevål, Kirkeveien 166, Oslo 0450, Norway.
Jagjit Singh BhamraDepartment of Immunology and Transfusion Medicine, Oslo University Hospital, Ullevål, Kirkeveien 166, Oslo 0450, Norway.
Maria Therese AhlenNorwegian National Unit for Platelet Immunology, Division of Diagnostics, University Hospital of North Norway, Sykehusveien 38, Tromsø 9019, Norway.
Pål Andre HolmeDepartment of Haematology, Oslo University Hospital Rikshospitalet, Sognsveien 20, Oslo 0372, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Klaus Torgårdsvei 3, Oslo 0372, Norway.
Anne-Hege AamodtDepartment of Neurology, Oslo University Hospital Rikshospitalet, Sognsveien 20, Oslo 0372, Norway.
Karolina SkagenDepartment of Neurology, Oslo University Hospital Rikshospitalet, Sognsveien 20, Oslo 0372, Norway.
Thor Håkon SkattørDepartment of Radiology and Nuclear Medicine, Oslo University Hospital Rikshospitalet, Sognsveien 20, Oslo 0372, Norway.
Mona SkjellandInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, Klaus Torgårdsvei 3, Oslo 0372, Norway; Department of Neurology, Oslo University Hospital Rikshospitalet, Sognsveien 20, Oslo 0372, Norway.
Markus Kh WiedmannDepartment of Neurosurgery, Oslo University Hospital Rikshospitalet. Sognsveien 20, Oslo 0372, Norway.
Oslo University Hospital · NOUniversity Hospital of North Norway · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesFatal complications have occurred after vaccination with ChAdOx1 nCoV-19, a vaccine against Covid-19. Vaccine-induced immune thrombotic thrombocytopenia (VITT) with severe outcome is characterized by venous thrombosis, predominantly in cerebral veins, thrombocytopenia and anti-PF4/polyanion antibodies. Prolonged headaches and cutaneous hemorrhages, frequently observed after the ChAdOx1 nCoV-19 vaccine, have therefore caused anxiety among vaccinees. We investigated whether these symptoms represent a mild form of VITT, with a potential for aggravation, e.g. in case of a second vaccination dose, or a different entity of vaccine complications MATERIALS AND

methodsWe included previously healthy individuals who had a combination of headache and spontaneous severe cutaneous hemorrhages emerging after the 1

resultsNone of the symptomatic vaccinees had cerebral vein thrombosis, hemorrhage or other pathology on MRI. Platelet counts were within normal range and no anti-PF4/polyanion platelet activating antibodies were found. Moreover, vasculitis markers, platelet activation markers and thrombin generation were normal. Furthermore, almost all symptoms resolved, and none had recurrence of symptoms after further vaccination with mRNA vaccines against Covid-19.

conclusionsThe combination of headaches and subcutaneous hemorrhage did not represent VITT and no other specific coagulation disorder or intracranial pathology was found. However, symptoms initially mimicking VITT demand vigilance and low threshold for a clinical evaluation combined with platelet counts and D-dimer.

Indexed as

COVID-19Purpura, Thrombocytopenic, IdiopathicThrombocytopeniaVaccinesAntibodiesChAdOx1 nCoV-19Cohort StudiesCOVID-19 VaccinesHumansPolyelectrolytesAntibodiesChAdOx1 nCoV-19COVID-19 VaccinesPolyelectrolytesVaccinesAdverse eventChAdOx1 nCoV vaccineCutaneous hemorrhageHeadache

Identifiers

PMID36403363
PMCPMC9670733
OpenAlexW4309259937

What OpenQuestion holds

Textmetadata
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.