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Sci Rep . Autoantibodies to protein S may explain rare cases of coagulopathy following COVID-19 vaccination

tetano

Editor, Senior Moderator
Sci Rep


. 2024 Oct 18;14(1):24512.
doi: 10.1038/s41598-024-75514-x. Autoantibodies to protein S may explain rare cases of coagulopathy following COVID-19 vaccination

Ahmet Yalcinkaya[SUP] 1 2 [/SUP], Marco Cavalli[SUP] 3 4 [/SUP], Maribel Aranda-Guillén[SUP] 5 [/SUP], Axel Cederholm[SUP] 6 [/SUP], Almira Güner[SUP] 6 [/SUP], Isabel Rietrae[SUP] 6 [/SUP], Hedvig Mildner[SUP] 6 [/SUP], Anish Behere[SUP] 6 [/SUP], Oskar Eriksson[SUP] 7 [/SUP], Laura Gonzalez[SUP] 8 [/SUP], Constantin Habimana Mugabo[SUP] 8 [/SUP], Anette Johnsson[SUP] 8 [/SUP], Tadepally Lakshmikanth[SUP] 8 [/SUP], Petter Brodin[SUP] 8 9 [/SUP], Mia Wadelius[SUP] 4 [/SUP], Pär Hallberg[SUP] 4 [/SUP], Nils Landegren[SUP] 6 5 [/SUP]



Affiliations
Abstract

While Coronavirus disease 2019 (COVID-19) vaccines have proven to be both effective and generally safe, rare but severe adverse events following immunization (AEFIs) are described. Autoantibodies to platelet factor-4 are associated with catastrophic thrombotic AEFIs, but comprehensive investigations of other autoantibodies are lacking. We aimed to detect and describe autoantibodies targeting coagulation-related proteins in a population-wide cohort (SWEDEGENE) including AEFIs attributed to COVID-19 vaccines in Sweden. Subjects were recruited from December 2020 to October 2022 and were stratified based on diagnosis and COVID-19 exposure. Screening was carried out in two phases, with a multiplex bead-based assay in the first subset (until September 2021) and with targeted assays for the second (until October 2022). Positivity was defined based on absolute, relative, and biological/technical thresholds. Patients with coagulation-related AEFIs were older and the Vaxzevria vaccine was overrepresented in this group. Two cases had antiphospholipid antibodies but none had PF4 antibodies. We identified six positives for protein S autoantibodies. Protein S concentrations were negatively correlated with autoantibody response in patients with immunoreactivity and functional analysis revealed low protein S activity in three subjects. Our population-wide analysis reveals cases with autoantibodies against protein S which possibly underlie coagulopathic AEFIs.

Keywords: Autoantibodies; Blood coagulation disorders; COVID-19; Protein S; Vaccines/adverse effects.

 
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