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A Rare Case of Cerebral Venous Thrombosis and Disseminated Intravascular Coagulation Temporally Associated to the COVID-19 Vaccine Administration.
D'Agostino, Vincenzo; Caranci, Ferdinando; Negro, Alberto; Piscitelli, Valeria; Tuccillo, Bernardino; Fasano, Fabrizio; Sirabella, Giovanni; Marano, Ines; Granata, Vincenza; Grassi, Roberta; Pupo, Davide; Grassi, Roberto.
  • D'Agostino V; Neuroradiology Unit, PO Ospedale del Mare, ASL NA1, via Enrico Russo, 80147 Naples, Italy.
  • Caranci F; Department of Medicine of Precision, School of Medicine, "Luigi Vanvitelli" University of Campania, 80147 Naples, Italy.
  • Negro A; Neuroradiology Unit, PO Ospedale del Mare, ASL NA1, via Enrico Russo, 80147 Naples, Italy.
  • Piscitelli V; Neuroradiology Unit, PO Ospedale del Mare, ASL NA1, via Enrico Russo, 80147 Naples, Italy.
  • Tuccillo B; Cardiology Unit, PO Ospedale del Mare, ASL NA1, via Enrico Russo, 80147 Naples, Italy.
  • Fasano F; Neuroradiology Unit, PO Ospedale del Mare, ASL NA1, via Enrico Russo, 80147 Naples, Italy.
  • Sirabella G; Neuroradiology Unit, PO Ospedale del Mare, ASL NA1, via Enrico Russo, 80147 Naples, Italy.
  • Marano I; Radiology Unit, PO Ospedale del Mare, ASL NA1, via Enrico Russo, 80147 Naples, Italy.
  • Granata V; Division of Radiology, "Istituto Nazionale Tumori IRCCS Fondazione Pascale-IRCCS di Napoli", I-80131 Naples, Italy.
  • Grassi R; Department of Medicine of Precision, School of Medicine, "Luigi Vanvitelli" University of Campania, 80147 Naples, Italy.
  • Pupo D; Department of Medicine of Precision, School of Medicine, "Luigi Vanvitelli" University of Campania, 80147 Naples, Italy.
  • Grassi R; Department of Medicine of Precision, School of Medicine, "Luigi Vanvitelli" University of Campania, 80147 Naples, Italy.
J Pers Med ; 11(4)2021 Apr 08.
Article in English | MEDLINE | ID: covidwho-1178321
Semantic information from SemMedBD (by NLM)
1. Thromboembolism PROCESS_OF Persons
Subject
Thromboembolism
Predicate
PROCESS_OF
Object
Persons
2. Vaccines ASSOCIATED_WITH Thrombocytopenia
Subject
Vaccines
Predicate
ASSOCIATED_WITH
Object
Thrombocytopenia
3. Several days PROCESS_OF Woman
Subject
Several days
Predicate
PROCESS_OF
Object
Woman
4. Radionuclide Imaging DIAGNOSES Subacute hemorrhage
Subject
Radionuclide Imaging
Predicate
DIAGNOSES
Object
Subacute hemorrhage
5. Right side of heart LOCATION_OF Arteries
Subject
Right side of heart
Predicate
LOCATION_OF
Object
Arteries
6. Brain LOCATION_OF Magnetic Resonance Imaging
Subject
Brain
Predicate
LOCATION_OF
Object
Magnetic Resonance Imaging
7. Sagittal Sinus Thrombosis COEXISTS_WITH Thrombosis
Subject
Sagittal Sinus Thrombosis
Predicate
COEXISTS_WITH
Object
Thrombosis
8. Magnetic Resonance Imaging DIAGNOSES Present
Subject
Magnetic Resonance Imaging
Predicate
DIAGNOSES
Object
Present
9. Pelvis LOCATION_OF Blood
Subject
Pelvis
Predicate
LOCATION_OF
Object
Blood
10. Thromboembolism PROCESS_OF Persons
Subject
Thromboembolism
Predicate
PROCESS_OF
Object
Persons
11. Vaccines ASSOCIATED_WITH Thrombocytopenia
Subject
Vaccines
Predicate
ASSOCIATED_WITH
Object
Thrombocytopenia
12. Several days PROCESS_OF Woman
Subject
Several days
Predicate
PROCESS_OF
Object
Woman
13. Radionuclide Imaging DIAGNOSES Subacute hemorrhage
Subject
Radionuclide Imaging
Predicate
DIAGNOSES
Object
Subacute hemorrhage
14. Right side of heart LOCATION_OF Arteries
Subject
Right side of heart
Predicate
LOCATION_OF
Object
Arteries
15. Brain LOCATION_OF Magnetic Resonance Imaging
Subject
Brain
Predicate
LOCATION_OF
Object
Magnetic Resonance Imaging
16. Sagittal Sinus Thrombosis COEXISTS_WITH Thrombosis
Subject
Sagittal Sinus Thrombosis
Predicate
COEXISTS_WITH
Object
Thrombosis
17. Magnetic Resonance Imaging DIAGNOSES Present
Subject
Magnetic Resonance Imaging
Predicate
DIAGNOSES
Object
Present
18. Pelvis LOCATION_OF Blood
Subject
Pelvis
Predicate
LOCATION_OF
Object
Blood
ABSTRACT
Globally, at the time of writing (20 March 2021), 121.759.109 confirmed COVID-19 cases have been reported to the WHO, including 2.690.731 deaths. Globally, on 18 March 2021, a total of 364.184.603 vaccine doses have been administered. In Italy, 3.306.711 confirmed COVID-19 cases with 103.855 deaths have been reported to WHO. In Italy, on 9 March 2021, a total of 6.634.450 vaccine doses have been administered. On 15 March 2021, Italian Medicines Agency (AIFA) decided to temporarily suspend the use of the AstraZeneca COVID-19 vaccine throughout the country as a precaution, pending the rulings of the European Medicines Agency (EMA). This decision was taken in line with similar measures adopted by other European countries due to the death of vaccinated people. On 18 March 2021, EMA's safety committee concluded its preliminary review about thromboembolic events in people vaccinated with COVID-19 Vaccine AstraZeneca at its extraordinary meeting, confirming the benefits of the vaccine continue to outweigh the risk of side effects, however, the vaccine may be associated with very rare cases of blood clots associated with thrombocytopenia, i.e., low levels of blood platelets with or without bleeding, including rare cases of cerebral venous thrombosis (CVT). We report the case of a 54-year-old woman who developed disseminated intravascular coagulation (DIC) with multi-district thrombosis 12 days after the AstraZeneca COVID-19 vaccine administration. A brain computed tomography (CT) scan showed multiple subacute intra-axial hemorrhages in atypical locations, including the right frontal and the temporal lobes. A plain old balloon angioplasty (POBA) of the right coronary artery was performed, without stent implantation, with restoration of distal flow, but with persistence of extensive thrombosis of the vessel. A successive thorax angio-CT added the findings of multiple contrast filling defects with multi-vessel involvement at the level of the left upper lobe segmental branches, of left interlobar artery, of the right middle lobe segmental branches and of the right interlobar artery. A brain magnetic resonance imaging (MRI) in the same day showed the presence of an acute basilar thrombosis associated with the superior sagittal sinus thrombosis. An abdomen angio-CT showed filling defects at the level of left portal branch and at the level of right suprahepatic vein. Bilaterally, it was adrenal hemorrhage and blood in the pelvis. An evaluation of coagulation factors did not show genetic alterations so as the nasopharyngeal swab ruled out a COVID-19 infection. The patient died after 5 days of hospitalization in intensive care.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Risk factors Topics: Vaccines Language: English Year: 2021 Document Type: Article Affiliation country: Jpm11040285

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study / Risk factors Topics: Vaccines Language: English Year: 2021 Document Type: Article Affiliation country: Jpm11040285