No changes in hemostasis after COVID-19-heterologous vaccination schedule: A subanalysis of the phase 2 CombiVacS study.

COVID-19 vaccine CombiVacS study anti-PF4 antibodies coagulation hemostasis heterologous vaccination thrombocytopenia

Journal

Research and practice in thrombosis and haemostasis
ISSN: 2475-0379
Titre abrégé: Res Pract Thromb Haemost
Pays: United States
ID NLM: 101703775

Informations de publication

Date de publication:
Jan 2023
Historique:
received: 07 06 2022
revised: 20 10 2022
accepted: 07 11 2022
pubmed: 24 1 2023
medline: 24 1 2023
entrez: 23 1 2023
Statut: ppublish

Résumé

Several cases of unusual thrombotic events and thrombocytopenia were described after vaccination with recombinant adenoviral vectors encoding the spike protein antigen of SARS-CoV-2. The objective of this study was to elucidate the impact of a COVID-19 heterologous vaccination schedule, including priming with adenovirus vaccine, on hemostasis profiles. The present study is a subanalysis of the CombiVacS clinical trial initiated in April 2021 that included adult participants previously vaccinated with a single dose of ChAdOx1-S. Between 8 and 12 weeks after vaccination, they were randomly assigned (2:1) to receive either BNT162b2 vaccine (intervention group, Platelet count from all participants after receiving BNT162b2 was within the normal range. Anti-PF4 antibodies were present in 26% and 18% of the subjects from the control and intervention groups, respectively, at day 28. In most cases, the levels of anti-PF4 antibodies were high before receiving BNT162b2. Serum from these participants did not activate platelets from healthy controls. There were no differences between the groups in PAI-1 and cfDNA plasma levels. According to the D-dimer plasma concentration, the thrombin generation test showed that none of the participants had a procoagulant profile. Our data suggest that the heterologous vaccination against COVID-19 with ChAdOx1-S and a second dose with BNT162b2 might be safe in terms of haemostasis.

Sections du résumé

Background UNASSIGNED
Several cases of unusual thrombotic events and thrombocytopenia were described after vaccination with recombinant adenoviral vectors encoding the spike protein antigen of SARS-CoV-2.
Objectives UNASSIGNED
The objective of this study was to elucidate the impact of a COVID-19 heterologous vaccination schedule, including priming with adenovirus vaccine, on hemostasis profiles.
Methods UNASSIGNED
The present study is a subanalysis of the CombiVacS clinical trial initiated in April 2021 that included adult participants previously vaccinated with a single dose of ChAdOx1-S. Between 8 and 12 weeks after vaccination, they were randomly assigned (2:1) to receive either BNT162b2 vaccine (intervention group,
Results UNASSIGNED
Platelet count from all participants after receiving BNT162b2 was within the normal range. Anti-PF4 antibodies were present in 26% and 18% of the subjects from the control and intervention groups, respectively, at day 28. In most cases, the levels of anti-PF4 antibodies were high before receiving BNT162b2. Serum from these participants did not activate platelets from healthy controls. There were no differences between the groups in PAI-1 and cfDNA plasma levels. According to the D-dimer plasma concentration, the thrombin generation test showed that none of the participants had a procoagulant profile.
Conclusion UNASSIGNED
Our data suggest that the heterologous vaccination against COVID-19 with ChAdOx1-S and a second dose with BNT162b2 might be safe in terms of haemostasis.

Identifiants

pubmed: 36685004
doi: 10.1016/j.rpth.2023.100049
pii: S2475-0379(23)00014-6
pmc: PMC9840220
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100049

Informations de copyright

© 2023 The Authors.

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Auteurs

Nora V Butta (NV)

Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain.

Elena G Arias-Salgado (EG)

Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain.

Elena Monzón Manzano (E)

Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain.

Paula Acuña (P)

Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain.

María Teresa Álvarez Román (MT)

Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain.

Antonio Buño-Soto (A)

Servicio de Análisis Clínicos, Hospital Universitario La Paz, Madrid, Spain.

Juan Carlos Ramos Ramos (JC)

Unidad de Enfermedades Infecciosas, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain.

Cristóbal Belda-Iniesta (C)

Instituto de Salud Carlos III - ISCIII, Madrid, Spain.

Jesús Frías (J)

Servicio de Farmacología Clínica, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain.
Departamento de Farmacología y Terapéutica, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain.
VACCELERATE: European Corona Vaccine Trial Accelerator Platform, European Union's Horizon 2020.
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.

Antonio J Carcas (AJ)

Servicio de Farmacología Clínica, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain.
Departamento de Farmacología y Terapéutica, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain.
VACCELERATE: European Corona Vaccine Trial Accelerator Platform, European Union's Horizon 2020.
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.

Lucía Martínez de Soto (LM)

Servicio de Farmacología Clínica, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain.
Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain.

Rosa de Miguel Buckley (R)

Unidad de Enfermedades Infecciosas, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain.

David Lora (D)

Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain.
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), CIBER de Epidemiología y Salud Pública (CIBERESP), Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain.

María Teresa García-Morales (MT)

Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain.
Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), CIBER de Epidemiología y Salud Pública (CIBERESP), Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain.

Alberto M Borobia (AM)

Servicio de Farmacología Clínica, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Madrid, Spain.
Departamento de Farmacología y Terapéutica, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
Spanish Clinical Research Network (SCReN-ISCIII), Madrid, Spain.
VACCELERATE: European Corona Vaccine Trial Accelerator Platform, European Union's Horizon 2020.
Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.

José Ramón Arribas (JR)

Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain.
Unidad de Enfermedades Infecciosas, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain.

Víctor Jiménez Yuste (V)

Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Instituto de Investigación Sanitaria del Hospital Universitario La Paz, Universidad Autónoma de Madrid, Madrid, Spain.

Classifications MeSH