Imaging and Hematologic Findings in Thrombosis and Thrombocytopenia after ChAdOx1 nCoV-19 (AstraZeneca) Vaccination

Radiology. 2022 Feb;302(2):319-325. doi: 10.1148/radiol.2021211546. Epub 2021 Aug 17.

Abstract

This case series reports six patients (four men and two women; median age, 38 years; interquartile range, 26-48 years) who presented with vaccine-induced thrombocytopenia and thrombosis beginning 3-26 days after receiving the first dose of the ChAdOx1 nCoV-19 (AstraZeneca) vaccine for COVID-19. The patients were admitted to a general hospital between 9 and 31 days after the first dose. All patients had strongly detected antiplatelet factor 4 antibodies and severe thrombosis. Laboratory features included thrombocytopenia and elevated d-dimer levels. Thrombotic events were predominantly venous; two patients had arterial or mixed arterial and venous thrombosis. All patients recovered after receiving intravenous immunoglobulin and nonheparin-based anticoagulation. © RSNA, 2021 An earlier incorrect version appeared online. This article was corrected on August 18, 2021.

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use
  • COVID-19 / prevention & control
  • ChAdOx1 nCoV-19 / adverse effects*
  • Diagnostic Imaging / methods*
  • Female
  • Fibrin Fibrinogen Degradation Products
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use
  • Lung / diagnostic imaging
  • Male
  • Middle Aged
  • Retrospective Studies
  • SARS-CoV-2
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / diagnostic imaging*
  • Thrombocytopenia / drug therapy
  • Venous Thrombosis / chemically induced*
  • Venous Thrombosis / diagnostic imaging*
  • Venous Thrombosis / drug therapy

Substances

  • Anticoagulants
  • Fibrin Fibrinogen Degradation Products
  • Immunoglobulins, Intravenous
  • fibrin fragment D
  • ChAdOx1 nCoV-19