Xu Long-Wei, Cao Feng, Tong Rui-Fang, Wang Chen-Yu, Zhang Ying-Hui
Department of Respiratory Medicine, Children's Hospital Affiliated to Zhengzhou University/Henan Children's Hospital, Zhengzhou 450000, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2023;25(9):966-970. doi: 10.7499/j.issn.1008-8830.2302074.
To study the relationship between coronavirus disease 2019 (COVID-19) vaccination and the risk of immune thrombocytopenia (ITP).
A retrospective analysis was conducted on children aged 3-17 years with newly diagnosed ITP who were hospitalized in Children's Hospital Affiliated to Zhengzhou University from November 2021 to December 2022. Clinical data and COVID-19 vaccination status were compared among three groups: ITP patients vaccinated within 12 weeks before onset, vaccinated more than 12 weeks before onset, and unvaccinated. Changes in serum immunoglobulin and complement levels were analyzed among five groups: ITP patients vaccinated <4 weeks before onset, 4-<8 weeks before onset, 8-<12 weeks before onset, ≥12 weeks before onset, and unvaccinated. A case-control design was used to estimate the risk of ITP: 387 children aged 3-17 years with fractures hospitalized during the same period in the emergency department of the hospital were selected as the control group, and the exposure to COVID-19 vaccination within 12, 8, and 4 weeks before onset in ITP children was compared to estimate the risk of ITP.
Among 129 ITP children, there were no statistically significant differences in age, gender, rate of preceding infections, absolute platelet count at initial diagnosis, absolute lymphocyte count at initial diagnosis, bleeding score, positive anti-nuclear antibody rate, absolute platelet count after 4 days of treatment, recurrence rate, and proportion of patients with disease duration ≥3 months among the three groups vaccinated within 12 weeks before onset, vaccinated more than 12 weeks before onset, and unvaccinated (>0.05). There was a statistically significant difference in serum immunoglobulin G, immunoglobulin A, and complement component 3 levels among the groups vaccinated <4 weeks, 4-<8 weeks, 8-<12 weeks, and ≥12 weeks before onset, and unvaccinated (<0.05). The risk estimation results showed that COVID-19 vaccination within 12 weeks, 8 weeks, and 4 weeks before onset did not increase the risk of ITP (>0.05).
COVID-19 vaccination does not increase the risk of ITP.
研究2019冠状病毒病（COVID-19）疫苗接种与免疫性血小板减少症（ITP）风险之间的关系。
对2021年11月至2022年12月在郑州大学附属儿童医院住院的3至17岁新诊断ITP患儿进行回顾性分析。比较三组患儿的临床资料和COVID-19疫苗接种状况：发病前12周内接种疫苗的ITP患者、发病前12周以上接种疫苗的患者和未接种疫苗的患者。分析五组患儿血清免疫球蛋白和补体水平的变化：发病前<4周接种疫苗的ITP患者、发病前4至<8周接种疫苗的患者、发病前8至<12周接种疫苗的患者、发病前≥12周接种疫苗的患者和未接种疫苗的患者。采用病例对照设计评估ITP风险：选取同期在该院急诊科住院的387例3至17岁骨折患儿作为对照组，比较ITP患儿发病前12周、8周和4周内COVID-19疫苗接种情况，以评估ITP风险。
在129例ITP患儿中，发病前12周内接种疫苗、发病前12周以上接种疫苗和未接种疫苗的三组患儿在年龄、性别、既往感染率、初诊时绝对血小板计数、初诊时绝对淋巴细胞计数、出血评分、抗核抗体阳性率、治疗4天后绝对血小板计数、复发率以及病程≥3个月患者的比例方面，差异均无统计学意义（>0.05）。发病前<4周、4至<8周、8至<12周、≥12周接种疫苗的患者与未接种疫苗的患者在血清免疫球蛋白G、免疫球蛋白A和补体成分3水平方面，差异有统计学意义（<0.05）。风险评估结果显示，发病前12周、8周和4周内接种COVID-19疫苗不会增加ITP风险（>0.05）。
COVID-19疫苗接种不会增加ITP风险。
