Recommendations for the clinical and laboratory diagnosis of VITT against COVID-19: Communication from the ISTH SSC Subcommittee on Platelet Immunology

Ishac Nazy; Ulrich J Sachs; Donald M Arnold; Steven E McKenzie; Phil Choi; Karina Althaus; Maria Therese Ahlen; Ruchika Sharma; Rachael F Grace; Tamam Bakchoul

doi:10.1111/jth.15341

Recommendations for the clinical and laboratory diagnosis of VITT against COVID-19: Communication from the ISTH SSC Subcommittee on Platelet Immunology

J Thromb Haemost. 2021 Jun;19(6):1585-1588. doi: 10.1111/jth.15341. Epub 2021 May 20.

Authors

Ishac Nazy^{1

2}, Ulrich J Sachs³, Donald M Arnold^{1

2}, Steven E McKenzie⁴, Phil Choi^{5

6}, Karina Althaus^{7

8}, Maria Therese Ahlen⁹, Ruchika Sharma¹⁰, Rachael F Grace¹¹, Tamam Bakchoul¹²

Affiliations

¹ Department of Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
² McMaster Centre for Transfusion Research, Hamilton, ON, Canada.
³ Department of Thrombosis and Haemostasis, Giessen University Hospital, Giessen, Germany.
⁴ Cardeza Foundation for Hematological Research, Thomas Jefferson University, Philadelphia, PA, USA.
⁵ Haematology Department, The Canberra Hospital, Canberra, ACT, Australia.
⁶ John Curtin School of Medical Research, ANU, Canberra, ACT, Australia.
⁷ Transfusion Medicine, Medical Faculty of Tuebingen, University of Tuebingen, Tuebingen, Germany.
⁸ Centre for Clinical Transfusion Medicine Tuebingen ZKT gGmbH, Tuebingen, Germany.
⁹ Norwegian National Unit for Platelet Immunology, University Hospital of North Norway, Tromso, Norway.
¹⁰ Versiti BloodCenter of Wisconsin Pediatric Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
¹¹ Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA, USA.
¹² Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, Tuebingen, Germany.

Abstract

Vaccine administration is under way worldwide to combat the current COVID-19 pandemic. The newly developed vaccines are highly effective with minimal adverse effects. Recently, the AstraZeneca ChadOx1 nCov-19 vaccine has raised public alarm with concerns regarding the rare, but serious, development of thrombotic events, now known as vaccine-induced immune thrombotic thrombocytopenia (VITT). These thrombotic events appear similar to heparin-induced thrombocytopenia, both clinically and pathologically. In this manuscript, the ISTH SSC Subcommittee on Platelet Immunology outlines guidelines on how to recognize, diagnose and manage patients with VITT.

Keywords: AstraZeneca ChadOx1 nCov-19 vaccine; COVID-19; platelet activation; thrombocytopenia; thrombosis.

MeSH terms

COVID-19 Vaccines
COVID-19*
ChAdOx1 nCoV-19
Clinical Laboratory Techniques
Communication
Humans
Pandemics
SARS-CoV-2
Vaccines*

Substances

COVID-19 Vaccines
Vaccines
ChAdOx1 nCoV-19