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Though COVID-19 vaccination is by and large safe for most people, some do develop allergic reactions to it. Body ache, swelling at injection site and low-grade fever are common and disappears within a couple of days. Many But sometimes, there may also be fatal complications after vaccination. One rare complication is blood clotting in the brain experienced by a miniscule percentage of vaccine recipients. This kind of blood clotting is known as cerebral venous thrombosis (CVT) and it can lead to strokes and death.
Taking cognisance of this complication, researchers at University College London conducted a study of people with cerebral venous thrombosis (CVT) following COVID-19 vaccination, to provide a clearer guide for clinicians trying to diagnose and treat such patients. The research, which is published in The Lancet, is the most detailed account of the characteristics of CVT, when it is caused by the novel condition vaccine-induced immune thrombotic thrombocytopenia (VITT).
What exactly is CVT?
VITT is a condition characterised by a blockage of the veins and a marked reduction of platelets, blood components which are an important part of the blood clotting system. The commonest and severest manifestation of VITT is CVT. Here, the veins draining blood from the brain become blocked.
Three principles of treatment for CVT
For the purpose of the study, researchers from the John Radcliffe Hospital in Oxford looked at the details at 70 patients with VITT-associated CVT following vaccination. They compared these patients to 25 patients with CVT but without the evidence of VITT. The said study provides support for the three principles of treatment established so far by the Expert Hematology Panel, based on early work at UCL and two other European sites.
- The use of non-heparin-based anticoagulation
- Administer treatments to try to reduce the level of the abnormal antibody that is implicated in this condition
- Avoid the strategy of trying to bring the platelet count back up to normal levels by giving platelet transfusions.
Benefit of intravenous immunoglobulin
Researchers saw that patients who were given intravenous immunoglobulin, a treatment in which the body is flooded with normal antibodies to try to reduce the effects of the abnormal one, were more likely to leave hospital alive. These patients are able to live an independent life rather than depending on carers or family to look after them. But researchers caution that though this kind of seem to be associated with better outcomes, one must exercise caution against reading too much into the findings of the observational study. They are of the view that reliable evidence about treatments can only be obtained in a randomised clinical trial.
Disadvantage of platelet transfusion
On the other hand, platelet transfusions were associated with a worse outcome in patients with VITT-associated CVT. Although observational data cannot prove any harm from this treatment approach, the study provides support for the concern that has already been raised about the potential harm of platelet transfusions.
(With inputs from IANS)
