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Cerebrovascular Complications of COVID-19 and COVID-19 Vaccination.
De Michele, Manuela; Kahan, Joshua; Berto, Irene; Schiavo, Oscar G; Iacobucci, Marta; Toni, Danilo; Merkler, Alexander E.
  • De Michele M; Stroke Unit, Emergency Department (M.D.M., I.B., O.G.S., D.T.), Sapienza University of Rome, Italy.
  • Kahan J; Clinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY (J.K., A.E.M.).
  • Berto I; Stroke Unit, Emergency Department (M.D.M., I.B., O.G.S., D.T.), Sapienza University of Rome, Italy.
  • Schiavo OG; Stroke Unit, Emergency Department (M.D.M., I.B., O.G.S., D.T.), Sapienza University of Rome, Italy.
  • Iacobucci M; Neuroradiology Unit, Department of Human Neurosciences (M.I.), Sapienza University of Rome, Italy.
  • Toni D; Stroke Unit, Emergency Department (M.D.M., I.B., O.G.S., D.T.), Sapienza University of Rome, Italy.
  • Merkler AE; Clinical and Translational Neuroscience Unit, Department of Neurology, Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY (J.K., A.E.M.).
Circ Res ; 130(8): 1187-1203, 2022 04 15.
Article in English | MEDLINE | ID: covidwho-1789065
ABSTRACT
The risk of stroke and cerebrovascular disease complicating infection with SARS-CoV-2 has been extensively reported since the onset of the pandemic. The striking efforts of many scientists in cooperation with regulators and governments worldwide have rapidly brought the development of a large landscape of vaccines against SARS-CoV-2. The novel DNA and mRNA vaccines have offered great flexibility in terms of antigen production and led to an unprecedented rapidity in effective and safe vaccine production. However, as mass vaccination has progressed, rare but catastrophic cases of thrombosis have occurred in association with thrombocytopenia and antibodies against PF4 (platelet factor 4). This catastrophic syndrome has been named vaccine-induced immune thrombotic thrombocytopenia. Rarely, ischemic stroke can be the symptom onset of vaccine-induced immune thrombotic thrombocytopenia or can complicate the course of the disease. In this review, we provide an overview of stroke and cerebrovascular disease as a complication of the SARS-CoV-2 infection and outline the main clinical and radiological characteristics of cerebrovascular complications of vaccinations, with a focus on vaccine-induced immune thrombotic thrombocytopenia. Based on the available data from the literature and from our experience, we propose a therapeutic protocol to manage this challenging condition. Finally, we highlight the overlapping pathophysiologic mechanisms of SARS-CoV-2 infection and vaccination leading to thrombosis.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombocytopenia / Thrombosis / Vaccines / Stroke / COVID-19 Type of study: Diagnostic study / Etiology study / Clinical Practice Guide Topics: Long Covid / Vaccines Limits: Humans Language: English Journal: Circ Res Year: 2022 Document Type: Article Affiliation country: Circresaha.122.319954

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Thrombocytopenia / Thrombosis / Vaccines / Stroke / COVID-19 Type of study: Diagnostic study / Etiology study / Clinical Practice Guide Topics: Long Covid / Vaccines Limits: Humans Language: English Journal: Circ Res Year: 2022 Document Type: Article Affiliation country: Circresaha.122.319954