Sekulovski Metodija, Mileva Niya, Vasilev Georgi Vasilev, Miteva Dimitrina, Gulinac Milena, Peshevska-Sekulovska Monika, Chervenkov Lyubomir, Batselova Hristiana, Vasilev Georgi Hristov, Tomov Latchezar, Lazova Snezhina, Vassilev Dobrin, Velikova Tsvetelina
Department of Anesthesiology and Intensive Care, University Hospital Lozenetz, Kozyak Str., 1407 Sofia, Bulgaria.
Medical Faculty, Sofia University, St. Kliment Ohridski, Kozyak 1 Str., 1407 Sofia, Bulgaria.
Biomedicines. 2023 Oct 17;11(10):2813. doi: 10.3390/biomedicines11102813.
Although abundant data confirm the efficacy and safety profile of the developed vaccines against COVID-19, there are still some concerns regarding vaccination in high-risk populations. This is especially valid for patients susceptible to thrombotic or bleeding events and hesitant people due to the fear of thrombotic incidents following vaccination. This narrative review focuses on various inherited and acquired thrombotic and coagulation disorders and the possible pathophysiologic mechanisms interacting with the coagulation system during immunization in view of the currently available safety data regarding COVID-19 vaccines. Inherited blood coagulation disorders and inherited thrombotic disorders in the light of COVID-19, as well as blood coagulation and thrombotic disorders and bleeding complications following COVID-19 vaccines, along with the possible pathogenesis hypotheses, therapeutic interventions, and imaging for diagnosing are discussed in detail. Lastly, the lack of causality between the bleeding and thrombotic events and COVID-19 vaccines is debated, but still emphasizes the importance of vaccination against COVID-19, outweighing the minimal risk of potential rare adverse events associated with coagulation.
尽管大量数据证实了已研发的抗新冠病毒疫苗的有效性和安全性,但对于高风险人群的疫苗接种仍存在一些担忧。这对于易发生血栓形成或出血事件的患者以及因担心接种疫苗后出现血栓事件而犹豫不决的人尤其如此。鉴于目前关于新冠病毒疫苗的安全数据,这篇叙述性综述聚焦于各种遗传性和获得性血栓形成及凝血障碍,以及免疫接种期间与凝血系统相互作用的可能病理生理机制。文中详细讨论了新冠疫情背景下的遗传性凝血障碍和遗传性血栓形成障碍,以及新冠病毒疫苗接种后的凝血和血栓形成障碍及出血并发症,同时还探讨了可能的发病机制假说、治疗干预措施以及诊断成像方法。最后,文中对出血和血栓事件与新冠病毒疫苗之间缺乏因果关系进行了辩论,但仍强调接种新冠疫苗的重要性,其重要性超过了与凝血相关的潜在罕见不良事件的最小风险。