TY - JOUR
T1 - Extensive splanchnic vein thrombosis after SARS-CoV-2 vaccination
T2 - A Vascular Liver Disease Group (VALDIG) initiative
AU - Maan, Raoel
AU - Lauw, Mandy N.
AU - China, Loise
AU - Patch, David
AU - Baiges, Anna
AU - Garcia-Pagan, Juan Carlos
AU - Hernández-Gea, Virginia
AU - Hilleret, Marie Noelle
AU - Tjwa, Eric T.
AU - Kounis, Ilias
AU - Bureau, Christophe
AU - Giguet, Baptiste
AU - Heurgué, Alexandra
AU - Ollivier-Hourmand, Isabelle
AU - Causse, Xavier
AU - Nery, Filipe
AU - Eshraghian, Ahad
AU - Plessier, Aurélie
AU - Murad, Sarwa Darwish
N1 - Publisher Copyright:
Copyright © 2024 American Association for the Study of Liver Diseases.
PY - 2024/11
Y1 - 2024/11
N2 - Background and Aims: Since the introduction of SARS-CoV-2 vaccines, several cases of vaccine-induced immune thrombocytopenia and thrombosis (VITT) have been described, especially cerebral vein thrombosis. We aimed to retrospectively collect all new cases of acute onset first or recurrent splanchnic vein thrombosis (SVT) following a recent SARS-CoV-2 vaccination within the Vascular Liver Disease Group network.Approach and Results: New cases of SVT were identified from April 2021 to April 2022; follow-up was completed on December 31, 2022. Criteria to define VITT were derived from previous studies. Data from a pre-COVID cohort of patients with SVT (N = 436) were used for comparison of clinical presentation, etiology, and outcome. Twenty-nine patients were identified with SVT occurring with a median of 11 days (range 2-76) after the first (48%), second (41%), or third (10%) vaccination (ChAdOx1 nCov-19 (n = 12) or BNT162b2 (n = 14), other (n = 3) Only 2 patients(7%) fulfilled criteria for definite VITT. Twenty (69%) had SVT at multiple sites, including 4 (14%) with concomitant extra-abdominal thrombosis. Only 28% had an underlying prothrombotic condition, compared to 52% in the pre-COVID SVT cohort (p = 0.01). Five patients (17%) underwent bowel resection for mesenteric ischemia, compared with 3% in pre-COVID SVT (p < 0.001). Two patients died shortly after diagnosis (7%). Conclusions: Although definite VITT was rare, in 72% of cases, no other cause for SVT could be identified following SARS-CoV-2 vaccination. These cases were different from patients with nonvaccine-related SVT, with lower incidence of prothrombotic conditions, higher rates of bowel ischemia, and poorer outcome. Although SVT after SARS-CoV-2 vaccination is rare in absolute terms, these data remain relevant considering ongoing revaccination programs.
AB - Background and Aims: Since the introduction of SARS-CoV-2 vaccines, several cases of vaccine-induced immune thrombocytopenia and thrombosis (VITT) have been described, especially cerebral vein thrombosis. We aimed to retrospectively collect all new cases of acute onset first or recurrent splanchnic vein thrombosis (SVT) following a recent SARS-CoV-2 vaccination within the Vascular Liver Disease Group network.Approach and Results: New cases of SVT were identified from April 2021 to April 2022; follow-up was completed on December 31, 2022. Criteria to define VITT were derived from previous studies. Data from a pre-COVID cohort of patients with SVT (N = 436) were used for comparison of clinical presentation, etiology, and outcome. Twenty-nine patients were identified with SVT occurring with a median of 11 days (range 2-76) after the first (48%), second (41%), or third (10%) vaccination (ChAdOx1 nCov-19 (n = 12) or BNT162b2 (n = 14), other (n = 3) Only 2 patients(7%) fulfilled criteria for definite VITT. Twenty (69%) had SVT at multiple sites, including 4 (14%) with concomitant extra-abdominal thrombosis. Only 28% had an underlying prothrombotic condition, compared to 52% in the pre-COVID SVT cohort (p = 0.01). Five patients (17%) underwent bowel resection for mesenteric ischemia, compared with 3% in pre-COVID SVT (p < 0.001). Two patients died shortly after diagnosis (7%). Conclusions: Although definite VITT was rare, in 72% of cases, no other cause for SVT could be identified following SARS-CoV-2 vaccination. These cases were different from patients with nonvaccine-related SVT, with lower incidence of prothrombotic conditions, higher rates of bowel ischemia, and poorer outcome. Although SVT after SARS-CoV-2 vaccination is rare in absolute terms, these data remain relevant considering ongoing revaccination programs.
UR - http://www.scopus.com/inward/record.url?scp=85198592656&partnerID=8YFLogxK
U2 - 10.1097/HEP.0000000000000787
DO - 10.1097/HEP.0000000000000787
M3 - Article
C2 - 38358465
AN - SCOPUS:85198592656
SN - 0270-9139
VL - 80
SP - 1147
EP - 1157
JO - Hepatology
JF - Hepatology
IS - 5
ER -
