Main Article Content
SARS-CoV2, ChAdOx1 nCov-19 vaccine, sickle cell disease, Vaso-occlusive crisis, vaccine induced immune thrombotic thrombocytopenia
Vaccines against acute respiratory syndrome Coronavirus 2(SARS-CoV2) are critical weapons to control the spread of the deadly Coronavirus 2019(COVId-19) virus worldwide. Although these vaccines are generally safe, their widespread use has produced reports of rare complications, including vaccine-induced immune thrombotic thrombocytopenia (VIITT), particularly in connection with ChAdOx1 nCov-19. We have identified three cases of sickle cell disease (SCD) experiencing a severe vaso-occlusive crisis (VOC) shortly after the vaccine. Despite being stable for a long time, they had fever with tachycardia, along with a significant rise in WBC, liver enzymes, particularly alkaline phosphate, with a remarkable drop in hemoglobin, and platelets and one of them probably had fatal TTP like syndrome. Given these findings, physicians and patients should exercise caution when taking this type of vaccine and be aware of these safety concerns.
2. Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger S. Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination. N Engl J Med. 2021 Apr 9:NEJMoa2104840. doi: 10.1056/NEJMoa2104840. Online ahead of print. PMID: 33835769
3. Nazy I, Sachs UJ, Arnold DM, McKenzie SE, Choi P, Althaus K, Ahlen MT, Sharma R, Grace RF, Bakchoul T. 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 Apr 22. doi: 10.1111/jth.15341. Online ahead of print.
4. Naik RP, Streiff MB, and Lanzkron S, Sickle cell disease and venous thromboembolism: what the anticoagulation expert needs to know, J Thromb Thrombolysis. 2013 Apr; 35(3): 352–358. doi: 10.1007/s11239-013-0895-y
5. Schultz NH, Sørvoll IH, Michelsen AE, Munthe LA, Lund-Johansen F, Ahlen MT, Wiedmann M, Aamodt AH, Skattør TH, Tjønnfjord GE, Holme PA. Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination. N Engl J Med. 2021 Jun 3; 384(22):2124-2130. doi: 10.1056 / NEJMoa2104882. Epub 2021 Apr 9. PMID: 33835768
6. Riad A, Pokorná A, Mekhemar M, Conrad J, Klugarová J, Koščík M, Klugar M, Attia S. Safety of ChAdOx1 nCoV-19 Vaccine: Independent Evidence from Two EU States. Vaccines (Basel). 2021 Jun 18; 9(6):673. doi: 10.3390/vaccines9060673
7. Alkindi S, Elsadek RA, Al-Madhani A, Al-Musalhi M, AlKindi SY, Al-Khadouri G, Al Rawahi B, Al-Ruqeishi S, Al-Yazeedi J, Wali YA, Al Shamakhi S, Al Rawahi M, Pathare AV. Impact of COVID-19 on vasooclusive crisis in patients with sickle cell anaemia. Int J Infect Dis. 2021 Mar 16; 106:128-133. doi: 10.1016/j.ijid.2021.03.044.