Qasim Hana, Rahhal Alaa, Husain Ahmed, Alammora Abdelkarim, Alsa'ed Khaled, Alsayed Ahmed Abdelghafar Masaad, Faiyoumi Baha, Maen AbuAfifeh Leen, Abu-Tineh Mohammad, Alshurafa Awni, Yassin Mohamed A
Hematology-Oncology Department, National Centre for Cancer Care & Research, Doha, Qatar.
Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO, USA.
J Blood Med. 2023 Apr 14;14:295-302. doi: 10.2147/JBM.S396026. eCollection 2023.
Immune thrombocytopenia (ITP) is a blood disorder in which antibodies coating platelets cause platelet destruction in the spleen with a resultant low platelet count and an increased tendency for bleeding. Coronavirus disease 2019 (COVID-19) is an illness caused by SARS-CoV-2. Though pneumonia and respiratory failure are major causes of morbidity and mortality, multisystemic complications were identified, including hematological ones. Several ITP relapse cases post-mRNA SARS-CoV-2 vaccines have been reported, and different pathophysiological theories have been proposed.
The objective of this study is to identify the causal relationship between mRNA COVID-19 vaccines and ITP relapse, to highlight the longer-term effect of these vaccines on the platelet count more than 6 months after receiving the vaccine, and to identify if there is a statistical difference between Comirnaty and Spikevax vaccines on ITP relapse rate.
In this retrospective study, 67 patients with known ITP were followed before and after receiving the mRNA COVID-19 vaccine. The follow-up parameters included platelet counts when available and bleeding symptoms. All patients were adults over 18 years old, with no other identified causes of thrombocytopenia. Forty-seven patients received the Comirnaty vaccine, and 20 patients received the Spikevax vaccine.
Data analysis showed 6% ITP relapse in the first 3 months, and a 10% relapse rate 3-6 months after receiving one of the mRNA COVID-19 vaccines, with no statically significant difference between the two vaccines.
mRNA COVID-19 vaccines increase the risk of ITP relapse and can lead to a prolonged reduction in platelet count in a proportion of ITP patients, with no statistically significant difference between Comirnaty and Spikevax vaccines.
免疫性血小板减少症（ITP）是一种血液疾病，其中覆盖血小板的抗体会导致脾脏中的血小板破坏，从而导致血小板计数降低和出血倾向增加。2019冠状病毒病（COVID-19）是由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的疾病。尽管肺炎和呼吸衰竭是发病和死亡的主要原因，但已发现多系统并发症，包括血液系统并发症。已有几例mRNA SARS-CoV-2疫苗接种后ITP复发的病例报道，并提出了不同的病理生理理论。
本研究的目的是确定mRNA COVID-19疫苗与ITP复发之间的因果关系，强调这些疫苗在接种后6个月以上对血小板计数的长期影响，并确定Comirnaty疫苗和Spikevax疫苗在ITP复发率上是否存在统计学差异。
在这项回顾性研究中，对67例已知ITP的患者在接种mRNA COVID-19疫苗前后进行了随访。随访参数包括可获得的血小板计数和出血症状。所有患者均为18岁以上的成年人，无其他已确定的血小板减少原因。47例患者接种了Comirnaty疫苗，20例患者接种了Spikevax疫苗。
数据分析显示，在接种mRNA COVID-19疫苗后的前3个月，ITP复发率为6%，3至6个月的复发率为10%，两种疫苗之间无统计学显著差异。
mRNA COVID-COVID-19疫苗会增加ITP复发的风险，并可能导致一部分ITP患者的血小板计数长期降低，Comirnaty疫苗和Spikevax疫苗之间无统计学显著差异。
