Vaccine-induced immune thrombotic thrombocytopenia after ChAdOx1 nCoV-19 vaccine in an older patient: Minireview and a case report

Rare cases of unusual thrombosis and thrombocytopenia after administration of the ChAdOx1 nCoV-19 vaccine (AstraZeneca) have been reported. The unusual symptoms are called vaccine-induced immune thrombotic thrombocytopenia (VITT). In the present study, a brief background about cases of unusual thrombosis and thrombocytopenia after administration of the ChAdOx1 nCoV-19 was provided. In addition, a description of a case of a 66-year-old woman who had received this vaccine and developed VITT was done. She presented to the hospital complaining of hematomas in the right upper limb 14 days after the ChAdOx1 nCoV-19 vaccine, without a history of trauma (Glasgow coma scale of 14) and thrombocytopenia even though signs of thrombosis were absent. Cranium computed tomography scan indicated intraparenchymal hematoma and cerebral thrombosis, besides anastomotic Labbe vein thrombosis. The woman received platelets transfusion, dexamethasone, and neuroprotection measures, but even so, on the twelfth post-operative day, she died of cerebral rebleeding. In conclusion, it is crucial to point out the immuno-hy-persensitivity mechanisms associated with ChAdOx1 nCoV-19 vaccine reactions, helping to reduce their occurrences and reinforcing confidence in vaccine administration.(c) 2022 Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences. CC_BY_NC_ND_4.0