Splanchnic Vein Thrombosis After COVID-19 Vaccination
The mother of a close friend died last month after suffering blood clots in the veins that drain the intestines. She was in her seventies and vaccinated for COVID-19 and sadly she died after emergency abdominal surgery. The daughter wondered if the death was vaccine-related.
Maan et al reported on one year of data from the Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands. Their results in the vaccinated are truly alarming:
“Twenty-nine patients were identified with SVT occurring with a median of 11 days (range 2–76) after the first (48%), second (41%), or third (10%) vaccination (ChAdOx1 nCov-19 (n=12) or BNT162b2 (n=14), other (n=3) Only 2 patients(7%) fulfilled criteria for definite VITT. Twenty (69%) had SVT at multiple sites, including 4 (14%) with concomitant extra-abdominal thrombosis. Only 28% had an underlying prothrombotic condition, compared to 52% in the pre-COVID SVT cohort (p=0.01). Five patients (17%) underwent bowel resection for mesenteric ischemia, compared with 3% in pre-COVID SVT (p<0.001). Two patients died shortly after diagnosis (7%).”
Maan, Raoel1; Lauw, Mandy N.2; China, Loise3; Patch, David4; Baiges, Anna5; Garcia-Pagan, Juan Carlos5; Hernández-Gea, Virginia5; Hilleret, Marie-Noelle6; Tjwa, Eric T.7; Kounis, Ilias8; Bureau, Christophe9; Giguet, Baptiste10; Heurgué, Alexandra11; Ollivier-Hourmand, Isabelle12; Causse, Xavier13; Nery, Filipe14,15; Eshraghian, Ahad16; Plessier, Aurélie17; Darwish Murad, Sarwa1. Extensive splanchnic vein thrombosis after SARS-CoV-2 vaccination: A Vascular Liver Disease Group (VALDIG) initiative. Hepatology ():10.1097/HEP.0000000000000787, February 15, 2024. | DOI: 10.1097/HEP.0000000000000787
Compared to a larger group of cases over many years before COVID, the vaccine blood clots were far more serious and deadly.
The main teaching point from this paper is among the vaccinated to take abdominal pain seriously and have a low threshold to get imaging to diagnose splanchnic blood clots before they become fatal.
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