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Abstract：
Several vaccine-induced thrombotic thrombocytopenia syndrome (VITTS) cases have been reported after the ChAdOx1 nCov-19 vaccination. The current study systematically reviewed the reported post-ChAdOx1 nCoV-19 vaccination thrombotic thrombocytopenia cases. Their laboratory and clinical features, as well as the diagnostic and therapeutic measures, were investigated. Online databases were searched until 25 August 2021. Studies reporting post-ChAdOx1 nCov-19 vaccination thrombotic thrombocytopenia syndrome (TTS) were included. Overall, 167 cases (21-77 years old) from 53 publications were included showing a female dominance of 1.75 times. About 85% of the cases exhibited the primary symptoms within the first two weeks post-vaccination. Headache was the most common initial symptom (>44.2%), and hemorrhage/thrombotic problems (22.46%), as well as discoordination/weakness/numbness/ hemiparesis/cyanotic toes (19.6%), were the most prevalent uncommon initial symptoms. Prothrombin time (PT), D-dimers, and C-reactive protein were the most remarkable increased laboratory parameters in 50.6%, 99.1%, and 55.6% of cases, respectively. In comparison, platelet and fibrinogen were the most remarkable decreased laboratory parameters in 92.7% and 50.5% of cases, respectively. Most VITT cases presented with cerebral venous thrombosis/cerebral venous sinus thrombosis, supraventricular tachycardia, transverse sinus/cerebral thrombosis, pulmonary embolism, and cerebral hemorrhage. Anti-PF4 antibody measurement through immunoassays and functional assays were positive in 86.2% and 73% of cases, respectively. About 31% of the cases died. Early diagnosis and proper therapeutic measures are important in ChAdOx1 nCov-19 vaccine-induced VITTS patients. Therefore, experts are recommended to know the corresponding clinical and laboratory features, as well as diagnostic methods. Elucidation of the pathophysiologic mechanism of ChAdOx1 nCov-19 vaccine-induced TTS deserves further investigation.
摘要：
在ChAdOx1nCov-19疫苗接种后，已经报道了几种疫苗诱导的血栓性血小板减少症（VITTS）病例。本研究系统回顾了报道的ChAdOx1nCoV-19疫苗接种后血栓性血小板减少症病例。他们的实验室和临床特征，以及诊断和治疗措施，被调查了。在线数据库一直搜索到2021年8月25日。纳入报告ChAdOx1nCov-19疫苗接种后血栓性血小板减少综合征（TTS）的研究。总的来说,包括53种出版物中的167例（21-77岁），显示女性占1.75倍。约85%的病例在疫苗接种后的前两周内表现出主要症状。头痛是最常见的初始症状（>44.2％），出血/血栓性问题（22.46%），以及不协调/虚弱/麻木/偏瘫/紫红色脚趾（19.6％），是最常见的不常见的初始症状。凝血酶原时间(PT),D-二聚体,和C反应蛋白是最显着的实验室参数增加50.6％，99.1%,55.6%的病例，分别。相比之下,在92.7%和50.5%的病例中，血小板和纤维蛋白原是最显着下降的实验室参数，分别。大多数VITT病例表现为脑静脉血栓形成/脑静脉窦血栓形成，室上性心动过速,横窦/脑血栓形成,肺栓塞,还有脑出血.通过免疫测定和功能测定的抗PF4抗体检测阳性的病例分别为86.2%和73%,分别。约31%的病例死亡。早期诊断和适当的治疗措施在ChAdOx1nCov-19疫苗诱导的VITTS患者中很重要。因此,建议专家了解相应的临床和实验室特征，以及诊断方法。ChAdOx1nCov-19疫苗诱导的TTS的病理生理机制的阐明值得进一步研究。
