Long-term outcome of patients with vaccine-induced immune thrombotic thrombocytopenia and cerebral venous sinus thrombosis

Introduction In early 2021, unanticipated thromboses, including cerebral venous sinus thrombosis (CVST) with thrombocytopenia, emerged as an adverse reaction (ADR) in patients who had been vaccinated with the AstraZeneca ChAdOx1 nCoV-19 vaccine. This ADR was termed vaccine-induced immune thrombotic thrombocytopenia (VITT) or thrombosis with thrombocytopenia syndrome (TTS). Although sporadic in nature, VITT can result in severe disease in the individual vaccinee. We followed up on the outcomes and status of neurological recovery of 49 cases of VITT with CVST that were reported to PEI. Method Assessment of the Extended Glasgow Outcome Scale (GOS-E) was performed within 3-6 months after the initial hospital admissions. Individual Glasgow Coma Scale (GCS) scores were reported by phone or electronically via a questionnaire or medical report by the treating physician of the hospital to which the patient was initially admitted. If a GCS score was not reported, an expert determined a score based on the patient's medical report. For most patients, follow-up was pursued about 3-6 months after hospital admission. The reported outcomes describe the patients' neurological status at 5-38 weeks (mean 20 weeks) after hospital admission. Outcomes were identified in 44 of the original 49 cases. Results Patient outcomes ranged from good recovery (13 patients, 29.6 %) to moderate disability (11 patients, 25.0 %) and severe disability or vegetative state (6 patients, 13.6 %). Fatal outcomes were reported in 14 patients (31.8 %). As anticipated, initial low GCS scores were associated with poor outcomes. By contrast, GCS scores > 10 were typically associated with improved neurological outcomes. Moreover, platelet count nadirs were correlated with patient outcomes. Low platelet counts were observed in fatal cases (GOS-E 1) with a mean count of 17,000 platelets/muL). Likewise, patients with better neurological outcomes (GOS-E scores of 5-6 and 7-8) presented with mean counts of 61,000 thrombocytes/muL. However, the course of the disease was not always predictable and showed significant individual variability. Conclusion We provide data on the outcome of VITT cases with CVST upon vaccination with the AstraZeneca adenoviral vector ChAdOx1 nCoV-19 COVID- 19 vaccine and found that the recovery of patients from CVST was very heterogeneous. While some patients exhibited good recoveries, others developed severe disabilities and major long-term complications. Collectively, our findings highlight the importance of paying attention to early signs of increased intracranial pressure and the onset of thrombocytopenia in patients with a recent history of vaccination with the AstraZeneca adenoviral vector ChAdOx1 nCoV-19 COVID-19 vaccine.

What Would Margaret Atwood Do? Designing for Ustopia in HCI

Utopia and dystopia can be seen to exist within each other. What is a desirable future for one might put someone else in an uncomfortable or conflicted position. Speculative design serves as a tool to let people experience situations through different perspectives of criticality. This paper argues to use speculative methodologies to design for Ustopia. We consider different perspectives from Margaret Atwood's novels "The Handmaid's Tale"and "The Testaments", and use these to define different critical perspectives that speculative design and speculative designers could take to pave the way to Ustopia. We present pastiche scenarios to illustrate how the perspectives could be applied to a transition that impacts all of us: the introduction of the COVID-19 vaccines. We use these pastiche scenarios and related work from the field of speculative design as examples to illustrate how the different perspectives might be integrated into one speculative experience. We propose that Ustopia can be used to harness and encompass such complexity. © 2021 Owner/Author.

Leveraging aesthetic expression in visualization to communicate positive facts during COVID-19 pandemic

The COVID-19 pandemic is a global public health crisis. Alongside the rapid geographical development and constantly rising number of confirmed cases, mixed spread of information and disinformation also plagued the public with distress, fear, and anxiety, transmitting a negative sentiment across many groups. Facing this, we experiment with the aesthetics of visualizations in educating laymen about positive facts during the pandemic. By blending artistic expressions into the visual encoding, we intend to tell a compelling data story describing the international scientific dedication in fighting the disease collaboratively. We present the visualization to collect feedback and evaluate the expected functions from general audience instead of traditional expert user groups. © 2020 Owner/Author.