Épisode 46 | COVID-19 : Thrombocytopénie thrombotique immunitaire et vaccins - a podcast by A.P.E.S.

La thrombocytopénie thrombotique immunitaire induite par certains vaccins contre la COVID, dont ceux produits par AstraZeneca et Johnson et Johnson, a fait couler beaucoup d’encre dans l’actualité. Quels sont les risques réels, les symptômes à surveiller et la conduite à adopter pour le pharmacien ? Pierre Lemieux, pharmacien au CIUSSS de la Mauricie et du Centre du Québec, a bien voulu nous éclairer sur le sujet.

Références :

1. Thrombocytopénie immunitaire prothrombotique induite par le vaccin – TIPIV (ou TTIV) en contexte de vaccination contre la COVID-19. INSPQ. Version du 19 avril 2021
https://publications.msss.gouv.qc.ca/msss/fichiers/directives-covid/dgaumip-030-rev1_thrombocytopenie-tipiv-%20vaccin-covid-19.pdf

2. Comité consultatif national de l’immunisation (CCNI). Recommandations sur l’utilisation des vaccins contre la COVID-19. Mise à jour du 23 avril 2021.
https://www.canada.ca/content/dam/phac-aspc/documents/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines/recommandations-utilisation-vaccins-covid-19-fr.pdf

3. Mahase E. AstraZeneca vaccine: Blood clots are “extremely rare” and benefits outweigh risks, regulators conclude BMJ 2021; 373 :n931 doi:10.1136/bmj.n931
https://www.bmj.com/content/373/bmj.n931

4. Les thromboses (caillots sanguins) et les vaccins contre la COVID-19.
Thrombose canada Foire aux questions. Avril 2021.
https://thrombosiscanada.ca/wp-uploads/uploads/2021/04/COVID-19-vaccine-and-Thrombosis-FAQs-April-2-2021_FR.pdf

5. Tacquet et al. Cerebral venous thrombosis: a retrospective cohort study of 513,284 confirmed COVID-19 cases and a comparison with 489,871 people receiving a COVID-19 mRNA vaccine, preprint
https://osf.io/a9jdq/

6. Katsanos et al. The Impact of SARS?CoV?2 on Stroke Epidemiology and Care: A Meta?Analysis Ann Neurol. 2020 Dec 9 : 10.1002/ana.25967 (2020)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753413/ ;

7. Andreas Greinacher et coll. Anti-SARS-CoV-2 Spike Protein and Anti-Platelet Factor 4 Antibody Responses Induced by COVID-19 Disease and ChAdOx1 nCov-19 vaccination, 09 April 2021, PREPRINT (Version 1) available at Research Square
https://www.researchsquare.com/article/rs-404769/v1

8. Scully et coll. Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 Vaccination. NEJM April 16, 2021.
DOI: 10.1056/NEJMoa2105385
https://www.nejm.org/doi/full/10.1056/NEJMoa2105385

9. Gowthami M et coll. Heparin-Induced Thrombocytopenia A Focus on Thrombosis. Arteriosclerosis, Thrombosis, and Vascular Biology. 2021;41:141–152
https://www.ahajournals.org/doi/pdf/10.1161/ATVBAHA.120.315445

10. CDC. Coronavirus Disease 2019 (COVID-19) Vaccines
https://www.cdc.gov/vaccines/acip/meetings/slides-2021-04-23.html

11. The Gamalaya Center Statement
https://sputnikvaccine.com/newsroom/pressreleases/the-gamaleya-center-statement/

12. Greinacher A. et coll. Towards Understanding ChAdOx1 nCov-19 Vaccine-induced Immune Thrombotic Thrombocytopenia (VITT). 2021. Preprint.
https://assets.researchsquare.com/files/rs-440461/v1/8eabf306-6fd4-4a89-a7a3-8f4d06c89a55.pdf

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