| Thiele 2021 | Retrospective analysis 69 suspected TTS | F 37 (71%) and M 15 (29%) | 46.0 (range, 31.0 to 60.3) | Germany | ChAdOx1 nCoV-19 | - Cerebral venous sinus thrombosis (71%)- Multiple thromboses (37%)- Twelve patients died. Non-survivors showed lower platelet counts compared to survivors.- Four patients with thrombocytopenia but without thrombosis presented with severe headache or cerebral bleeding. |
| Althaus 2021 | 8 patients (6 to 20 days) | 5 F/3M | 41.5 (range, 24 to 53) | | ChAdOx1 nCoV-19 | - Median platelet count of 46.5×109 /L (range, 8-92).- Three had a fatal outcome and five were successfully treated.- Autopsies showed arterial and venous thromboses in various organs and the occlusion of glomerular capillaries by hyaline thrombi.- High-titre antibodies against PF4- Contribution of antibody-mediated platelet activation in the pathogenesis of VITT |
| Reilly-Stitt 2021 | | | | | | - Thrombosis at unusual sites- Detection of anti-PF4 antibodies |
| Huynh 2021 | 5 patients (14–40 days) | 40% female | 44 (range, 35 to 72) | India | single dose of the ChAdOx1 nCoV-19 vaccine | - Antibodies against PF4 |
| Schultz et al 2021 | 5 patients in a population of more than 130,000 vaccinated persons (7 to 10 days) | | 32 to 54 | | ChAdOx1 nCoV-19 | - High levels of antibodies to PF 4–polyanion complexes- Rare vaccine-related variant of spontaneous heparin-induced thrombocytopenia- Severe cerebral venous thrombosis with intracranial haemorrhage, and the outcome was fatal in three.- Unusual sites and concomitant thrombocytopenia |
| Greinacher 2021 | 11 patients (5 to 16 days) | 9F/2M | 36 (range, 22 to 49) | Germany and Austria | ChAdOx1 nCov-19 | - Moderate-to-severe thrombocytopenia- Unusual thrombosis, particularly cerebral venous thrombosis and splanchnic-vein thrombosis- Disseminated intravascular coagulation in 5 of the patients on the basis of the combination of greatly elevated d-dimer levels (>10.0 mg per litre)- Pulmonary embolism- Other thromboses- Of the 6 patients with available fibrinogen levels, 4 had hypofibrinogenemia. |
| Holm 2021 | 5 patients (7 to 10 days) | 32 to 54 | 4F/1M | Oslo | ChAdOx1 nCoV-19 | - Four patients had major cerebral haemorrhage and three patients died.- Increased levels of innate immune response cytokines and markers of systemic inflammation- Extensive degranulation of neutrophils, and tissue and endothelial damage.- Activation of neutrophils- Increased levels of circulating H3Cit, dsDNA, and myeloperoxidase–DNA complex. |
| Sessa 2021 | out of 13.6 million | ≤ 50 | Female | US | - At least one dose of COVID-19 mRNA vaccines | - 61 cases were reported with a total of 68 thromboembolic events (1 case per 222,951 vaccinated). |
| Tiede 2021 | Single-centre cohort (2 weeks) | Female | - 1F (41) - 4F (61 to 67) | Hannover | ChAdOx1 | - Cerebral venous sinus thrombosis- Splanchnic vein thrombosis- Arterial cerebral thromboembolism, and thrombotic microangiopathy.- Elevated D-dimer- Autoantibodies against PF4 |
| Mauriello 2021 | 3 patients | | | UK | First dose of ChAdOx1 nCOV-19 | - Fatal thromboembolism- Low platelet counts- Presence of anti-PF4 antibodies- Pre-existing condition of thrombocytopenia due to myelodysplasia. |
| 23 patients (6 to 24 days) | M | 58 | | ChAdOx1nCoV-19 vaccine | - Severe thrombocytopenia- Low fibrinogen serum levels- Marked increase of D-dimer serum levels.- Thrombi detected in the capillaries of glomerular tufts.- In the hearth, thrombi observed in veins and capillaries.- In the liver, voluminous fibrin thrombi in the branches of the portal vein.- In the brain, microthrombi in the capillaries of the choroid plexuses.- Diffuse haemorrhagic necrosis observed in the intestinal wall- Low fibrinogen serum- Very high D-dimers levels (39.000 ug/L, reference range 0-200 ug/L). |
| Smadja 2021 | 1197 cases | F:708 (59.1%) | 76 (18 to 102) | | Comirnaty | - Thrombotic events |
| Smadja 2021 | 325 cases | F: 173 (53.2%) | 72 (19 to 102) | | Moderna | - Thrombotic events |
| Smadja 2021 | 639 cases | F: 332 (52%) | 67 (19 to 99) | | AZD1222 | - Thrombotic events |
| Krzywicka 2021 | 213 cerebral venous sinus thrombosis cases | | | Europe | - ChAdOx1 nCov-19-BNT162b2- mRNA-1273 | - Thrombocytopenia in 107/187 CVST cases- Cerebral venous sinus thrombosis- Mortality was 49%. |
| Perry 2021 | 70 patients | F: 39 (35.71%) | 47 (32 to 55) | UK | ChAdOx1 (Oxford–AstraZeneca) | - VITT- Cerebral venous thrombosis- Intracranial veins thrombosed and more frequently had extracranial thrombosis compared with non- VITT- Lowest platelet count below 150×10? per L - D-dimer, the highest value greater than 2,000 μg/L |
| Boonyawat and Angchaisuksiri | 5 VITT cases | F (60%) | 31 | Thailand | ChAdOx1 n-CoV-19 | - Severe headache- Marked thrombocytopenia, and a markedly elevated D-dimer level but no evidence of cerebral vein thrombosis |
| Bhuyan 2021 | 13 cases of TTS (14 days) | | 45 to 85 | | second dose of AZD1222 | - 8 patients with pulmonary embolism, co-occurring with cerebral venous sinus thrombosis in 2 patients- 1 patient with CVST occurring alone- 1 patient with deep vein thrombosis- 1patient with thrombotic stroke- 2 patients with unspecified embolisms |
| Billy 2021 | 27 cases | 60 (21 to 74) | 13 F/14 M | | ChAdOx1 nCov-19 | - Atypical thrombosis- Of 16 patients tested, 12 were positive for anti-PF4 antibodies.- Mortality rate of 30% |
| Cari 2021 | Eudravigilance | Matched | Matched | | -ChAdOx1 nCoV-19- BNT162b2 | - Higher rate of thrombo-haemorrhagic events in ChAdOx1 nCoV-19 than BNT162b2 recipients.- Thrombosis and thrombocytopenia were more frequent in young people (18–24 years) and adult females (25–60 years).- In BNT162b2 recipients, the frequency of thrombo-haemorrhagic events, was not increased compared to that in the general population. |
| Andrews 22 | over 45 million COVID-19 vaccine eligible individuals | | | UK | -ChAdOx1 nCoV-19- BNT162b2 | - Thrombotic episodes and thrombocytopenia in adults under 65 years of age within a month of a first dose of ChAdOx1- Cerebral venous thromboses and venous thromboses at other sites, in those aged 15-64 years of age with the greatest elevated risk within 4- 13 days after vaccination in those aged 15-39 years.- No side effects after the BNT162b2 vaccine. |
| Sørvoll 2021 | 492 patients (11 to 35 days) | | | Norway | Ad26.COV2.S | - Low thrombocytopenia- Antibodies to PF4/polyanion-complexes |
| Tobaiqy 2021 | 17 million vaccinated people | F 19/M 9 | 57% aged over 85 | | ChAdOx1-S | - Thromboembolic reports was 28, of which 19- Pulmonary embolism; one fatality to thrombosis- Immune complexes that including T cell-mediated processes |
| Pottegård et al., 2021 | 281,264 people (28 days) | | | UK | ChAdOx1 nCov-19 | - Cerebral venous thrombosis- Higher rate of thrombocytopenia/coagulation |
| Wolf 2021 | 5 patients (10 days) | 4F/1M | 32 to 54 | | ChAdOx1 nCoV-19 | - Thrombosis at unusual sites and thrombocytopenia- Pulmonary, abdominal, portal and intracranial thromboembolic- Mild to moderate thrombocytopenia- Intracranial venous sinus thrombosis |
| Hunter, 2021 | 6 patients | | | | Ad26.COV2.S | - Severe thrombosis |
| Gras-Champel 2021 | 11,206 reports | 13F/14M | 60 (21 to 74) | France | VaxZevria® | - Coagulation disorders namely thrombocytopenia- Disseminated intravascular coagulation- Venous and/or arterial thrombosis |
| Pavord 2021 | 40 patients | F: 25 | 21 to 76 | U.K. | - Second dose of ChAdOx1 nCoV-19 (n=5)- mRNA-1273 (n=2)- BNT162b2 (n=33). | - No symptoms after second dose- VITT after receiving their first dose of ChAdOx1 nCoV-19 |
| Cacciola 2021 | 60 patients (7 days) | 20 F/40M | 55±10 years | Italy | ChAdOx1 nCoV-19 | - Thrombocytopenia (60±5×109/L)- Longer prothrombin time (28±10 s)- Activated partial thromboplastin time (50±10 s),- Lower fibrinogen (80±20 mg/dl), higher D-dimer (550±100 mg/L). |
| Lee 2022 | 68 patients (12 to 17 days) | F (53%) | 51 (range, 30 to 69) | Canada | ChAdOx1 nCoV-19 | - Three patients had thrombocytopenia and thrombosis with D-dimer levels >4.0 mg/L -- Patients with VITT were treated successfully with intravenous immunoglobulin, non-heparin anticoagulants and corticosteroids. |
| See 2022 | 57 TTS | F (69%) | 44.5 (range, 18 to 70 years) | US | Ad26.COV2.S (n= 54) mRNA vaccine (n= 3) | - Venous thrombosis (98%).- Nine TTS cases (17%) had arterial thrombosis (including 8 with an accompanying venous thrombosis).- Median platelet count nadir was 32.5×109 cells/L- Anti-PF4 antibody ELISA test results were positive in 44 (81%), negative in 3 (6%), and not done in 7 (13%) |