tetano
Editor, Senior Moderator
J Blood Med
. 2023 Apr 14;14:295-302.
doi: 10.2147/JBM.S396026. eCollection 2023.
Immune Thrombocytopenia Relapse in Patients Who Received mRNA COVID-19 Vaccines
Hana Qasim[SUP] 1 2 [/SUP], Alaa Rahhal[SUP] 3 [/SUP], Ahmed Husain[SUP] 4 [/SUP], Abdelkarim Alammora[SUP] 5 [/SUP], Khaled Alsa'ed[SUP] 5 [/SUP], Ahmed Abdelghafar Masaad Alsayed[SUP] 5 [/SUP], Baha Faiyoumi[SUP] 5 [/SUP], Leen Maen AbuAfifeh[SUP] 5 [/SUP], Mohammad Abu-Tineh[SUP] 1 [/SUP], Awni Alshurafa[SUP] 1 [/SUP], Mohamed A Yassin[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Immune thrombocytopenia (ITP) is a blood disorder in which antibodies coating platelets cause platelet destruction in the spleen with a resultant low platelet count and an increased tendency for bleeding. Coronavirus disease 2019 (COVID-19) is an illness caused by SARS-CoV-2. Though pneumonia and respiratory failure are major causes of morbidity and mortality, multisystemic complications were identified, including hematological ones. Several ITP relapse cases post-mRNA SARS-CoV-2 vaccines have been reported, and different pathophysiological theories have been proposed.
Purpose: The objective of this study is to identify the causal relationship between mRNA COVID-19 vaccines and ITP relapse, to highlight the longer-term effect of these vaccines on the platelet count more than 6 months after receiving the vaccine, and to identify if there is a statistical difference between Comirnaty and Spikevax vaccines on ITP relapse rate.
Patients and methods: In this retrospective study, 67 patients with known ITP were followed before and after receiving the mRNA COVID-19 vaccine. The follow-up parameters included platelet counts when available and bleeding symptoms. All patients were adults over 18 years old, with no other identified causes of thrombocytopenia. Forty-seven patients received the Comirnaty vaccine, and 20 patients received the Spikevax vaccine.
Results: Data analysis showed 6% ITP relapse in the first 3 months, and a 10% relapse rate 3-6 months after receiving one of the mRNA COVID-19 vaccines, with no statically significant difference between the two vaccines.
Conclusion: mRNA COVID-19 vaccines increase the risk of ITP relapse and can lead to a prolonged reduction in platelet count in a proportion of ITP patients, with no statistically significant difference between Comirnaty and Spikevax vaccines.
Keywords: COVID-19; ITP; relapse; vaccine.
. 2023 Apr 14;14:295-302.
doi: 10.2147/JBM.S396026. eCollection 2023.
Immune Thrombocytopenia Relapse in Patients Who Received mRNA COVID-19 Vaccines
Hana Qasim[SUP] 1 2 [/SUP], Alaa Rahhal[SUP] 3 [/SUP], Ahmed Husain[SUP] 4 [/SUP], Abdelkarim Alammora[SUP] 5 [/SUP], Khaled Alsa'ed[SUP] 5 [/SUP], Ahmed Abdelghafar Masaad Alsayed[SUP] 5 [/SUP], Baha Faiyoumi[SUP] 5 [/SUP], Leen Maen AbuAfifeh[SUP] 5 [/SUP], Mohammad Abu-Tineh[SUP] 1 [/SUP], Awni Alshurafa[SUP] 1 [/SUP], Mohamed A Yassin[SUP] 1 [/SUP]
Affiliations
- PMID: 37082002
- PMCID: PMC10112532
- DOI: 10.2147/JBM.S396026
Abstract
Background: Immune thrombocytopenia (ITP) is a blood disorder in which antibodies coating platelets cause platelet destruction in the spleen with a resultant low platelet count and an increased tendency for bleeding. Coronavirus disease 2019 (COVID-19) is an illness caused by SARS-CoV-2. Though pneumonia and respiratory failure are major causes of morbidity and mortality, multisystemic complications were identified, including hematological ones. Several ITP relapse cases post-mRNA SARS-CoV-2 vaccines have been reported, and different pathophysiological theories have been proposed.
Purpose: The objective of this study is to identify the causal relationship between mRNA COVID-19 vaccines and ITP relapse, to highlight the longer-term effect of these vaccines on the platelet count more than 6 months after receiving the vaccine, and to identify if there is a statistical difference between Comirnaty and Spikevax vaccines on ITP relapse rate.
Patients and methods: In this retrospective study, 67 patients with known ITP were followed before and after receiving the mRNA COVID-19 vaccine. The follow-up parameters included platelet counts when available and bleeding symptoms. All patients were adults over 18 years old, with no other identified causes of thrombocytopenia. Forty-seven patients received the Comirnaty vaccine, and 20 patients received the Spikevax vaccine.
Results: Data analysis showed 6% ITP relapse in the first 3 months, and a 10% relapse rate 3-6 months after receiving one of the mRNA COVID-19 vaccines, with no statically significant difference between the two vaccines.
Conclusion: mRNA COVID-19 vaccines increase the risk of ITP relapse and can lead to a prolonged reduction in platelet count in a proportion of ITP patients, with no statistically significant difference between Comirnaty and Spikevax vaccines.
Keywords: COVID-19; ITP; relapse; vaccine.