背景:我们推测,在2019年冠状病毒病(COVID-19)疫苗接种后,亚临床血栓形成可能通过免疫/炎症反应与止血之间的串扰而频繁发生。为了检验这个假设,我们在志愿者中进行了21天的COVID-19疫苗接种后,测量了血栓形成相关参数.
方法:在疫苗接种前1天和疫苗接种后1、3、7、14和21天(阿斯利康COVID-19疫苗:ChAdOx1-S/nCoV-19,CTMAV563)对一名72岁韩国男子进行了以下参数测量:全血细胞计数,血小板指数,凝血酶受体激活肽诱导的血小板聚集,凝血酶原时间,活化部分凝血活酶时间,D-二聚体,凝血酶-抗凝血酶III复合物(TAT),纤溶酶-α2抗纤溶酶复合物(PAP),血管性血友病因子(vWF)抗原和活性,纤溶酶原激活物抑制剂-1(PAI-1),蛋白C和蛋白S抗原和活性,狼疮抗凝药,纤维蛋白原降解产物,和纤溶酶原。我们发现TAT从0.7ng/mL(基线)显著增加至21.7ng/mL(第1天)。PAI-1水平从7.2ng/mL(基线)短暂增加至10.9ng/mL(第3天),随后PAP水平从0.9ng/mL(基线)降至0.3μg/mL(第7天),表明纤溶酶的产生被PAI-1抑制。
结论:由于PAI-1的增加,血栓形成因子增加(如蛋白S降低)和纤溶活性降低是导致COVID-19疫苗接种后血栓形成的潜在因素。血小板指数的顺序测量,TAT,PAP,蛋白C,蛋白质S,vWF,D-二聚体,COVID-19疫苗接种后的PAI-1提供了信息。
BACKGROUND: We speculated that subclinical thrombosis may occur frequently through crosstalk between immune/inflammatory reactions and hemostasis after corona virus disease-2019 (COVID-19) vaccination. To test this hypothesis, we measured thrombosis-related parameters after COVID-19 vaccination in a volunteer for 21 days.
METHODS: The following parameters were measured in a 72-year-old Korean man at 1 day before vaccination and on days 1, 3, 7, 14, and 21 post vaccination (AstraZeneca COVID-19 vaccine: ChAdOx1-S/nCoV-19, CTMAV563): complete blood count, platelet indices, thrombin receptor-activating peptide-induced platelet aggregation, prothrombin time, activated partial thromboplastin time, D-dimer, thrombin-antithrombin III complex (TAT), plasmin-α2 antiplasmin complex (PAP), von Willebrand factor (vWF) antigen and activity, plasminogen activator inhibitor-1 (PAI-1), protein C and protein S antigen and activity, lupus anticoagulant, fibrinogen degradation product, and plasminogen. We found that the TAT had significantly increased from 0.7 ng/mL (baseline) to 21.7 ng/mL (day 1). There was a transient increase in the PAI-1 level from 7.2 ng/mL (baseline) to 10.9 ng/mL (day 3), followed by a decrease in PAP level from 0.9 ng/mL (baseline) to 0.3 μg/mL (day 7), suggesting that plasmin generation is suppressed by PAI-1.
CONCLUSIONS: Increased thrombotic factors (such as decreased protein S) and decreased fibrinolytic activity due to increased PAI-1 were potential factors causing thrombogenesis after COVID-19 vaccination. Sequential measurement of platelet indices, TAT, PAP, protein C, protein S, vWF, D-dimer, and PAI-1 following COVID-19 vaccination was informative.