A recent study published in the journal Frontiers of Medicine has identified a potential link between the CoronaVac vaccine from Sinovac Biotech and immune thrombotic thrombocytopenic purpura (TTP). The study describes two cases of TTP that occurred after individuals received the CoronaVac vaccine, suggesting a connection between this type of vaccine and the development of TTP. Additionally, the study analyzed the incidence of TTP in the Nanjing area of China, indicating a possible relationship between COVID-19 vaccination and the occurrence of TTP.
In the first case, a 23-year-old woman experienced symptoms of TTP three days after receiving her second dose of the CoronaVac vaccine. She initially had dizziness and weakness, which progressed to thrombocytopenia, anemia, elevated LDH and α-HBDH levels, decreased platelet count, decreased hemoglobin levels, and the presence of schistocytes in her peripheral blood smears. The patient’s condition improved with the use of glucocorticoids, plasma exchange, and rituximab, leading to a gradual return to normal levels of ADAMTS13 antigen and inhibitory antibodies.
The second case involved a 45-year-old woman who developed fever and muscle soreness five days after receiving her second dose of the CoronaVac vaccine. She presented with high fever, hematological abnormalities, acute renal failure, and thrombocytopenia. After being diagnosed with TTP based on the presence of schistocytes in her blood smears and low ADAMTS13 levels, she was treated with plasma exchange and glucocorticoids, resulting in her recovery.
The study also examined TTP cases from 14 hospitals in the Nanjing area, revealing an increase in TTP incidence from 2019 to 2022 that may be linked to COVID-19 vaccination. While TTP is considered rare, with approximately one new case per million people, the incidence rates have risen in the years following the introduction of COVID-19 vaccination campaigns. Although a direct causal relationship has not been established, there is speculation that the increase in TTP cases could be related to the vaccines.
The report discusses the potential mechanisms through which COVID-19 vaccines might trigger TTP, focusing on the autoimmune response that could cross-react with ADAMTS13, leading to its deficiency and the development of TTP. It stresses the importance of accurately and promptly diagnosing TTP to ensure appropriate treatment and avoid exacerbating the condition. Additionally, the report highlights the critical role of plasma exchange and immunosuppression in treating TTP, as demonstrated by the successful management of the cases reported in the study.