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Guide to AHA for blood clots associated with the COVID-19 vaccine

A recently published report offers guidance on rare conditions associated with COVID-19, as well as vaccines against the virus.

The report was released today by the American Heart Association / American Stroke Association in response to last Friday’s decision by the Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA) to repeal an earlier “pause” with the Johnson & Johnson (Janssen) vaccine.

This pause was introduced after reports of a possible link between the J&J vaccine and cerebral venous sinus thrombosis (CVST) and thrombosis-thrombocytopenia syndrome (TTS, blood clots plus low blood platelets) were reported. CVST and TTS have also been associated with patients in Europe and Canada who received the AstraZeneca COVID-1

9 vaccine.

However, the new report notes that these conditions are very rare.

“The risk of CVST due to COVID-19 infection is 8 to 10 times higher than the risk of CVST after receiving a vaccine against COVID-19”, lead author Karen L. Fury, PhD, Chair of the Department of Neurology at Warren Alpert Medical School at Brown University, Providence, Rhode Island, said in a press release.

“The public can be reassured by the CDC and FDA investigation and these statistics – the likelihood of developing CVST after a COVID-19 vaccine is extremely low,” Fury said, adding that the authors “urge all adults to get one of the approved COVIDs.” -19 vaccines. “

The new guide, which was published online today in Strike, discusses signs and symptoms of CVST and TTS, as well as vaccine-induced immune thrombotic thrombocytopenia (VITT). He also recommends the best treatment options for these conditions.

Estimated 81 million patients

In their analysis, the researchers evaluated a database of 59 health organizations and 81 million patients, 98% of whom were in the United States.

Of the nearly 514,000 patients diagnosed with COVID-19 between January 2020 and March 2021, 20 were also diagnosed with CVST.

Among the approximately 490,000 adults who received either Pfizer or Moderna vaccines, no cases of thrombocytopenia were diagnosed.

Fury reiterated that CVST blood clots “are very rare side effects,” but recommended that any patient in the emergency department with a suspected clot be tested immediately to see if they have received the COVID vaccine in the past few weeks.

For those who have recently received the COVID-19 vaccine, the suspected clot should be treated with non-heparin anticoagulants, Fury said.

“Heparin products should not be given in any dose if CVST, TTS or VITT is suspected. With proper treatment, most patients can fully recover,” she added. The report includes additional, detailed treatment recommendations if one of these conditions is suspected.

Rare events

The authors note that TTS / VITT cases occurred up to 2 1/2 weeks after receiving the J&J vaccine in the United States and up to 3 1/2 weeks after receiving the AstraZeneca vaccine in Europe.

A report by the CDC and FDA on April 23 noted that of the nearly 7 million adults who received the J&J vaccine, the agencies investigated only 15 reported cases of TTS.

A report by the European Medicines Agency on 7 April noted that of the more than 25 million people who received the AstraZeneca vaccine in the European Union, he had identified 62 cases of CVST.

A statement from the American Heart Association / American Stroke Association called for “everyone to be vaccinated against COVID-19” as soon as possible.

“We are convinced that the benefits of vaccination far outweigh the very small, rare risks,” the organizations said. “The risks of vaccination are also far less than the risk of COVID-19 and its potentially fatal consequences.”

Strike. Published online on April 29, 2021. Full text

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