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Case Report

A Rare Case of Cerebral Venous Thrombosis and Disseminated Intravascular Coagulation Temporally Associated to the COVID-19 Vaccine Administration

1
Neuroradiology Unit, PO Ospedale del Mare, ASL NA1, via Enrico Russo, 80147 Naples, Italy
2
Department of Medicine of Precision, School of Medicine, “Luigi Vanvitelli” University of Campania, 80147 Naples, Italy
3
Cardiology Unit, PO Ospedale del Mare, ASL NA1, via Enrico Russo, 80147 Naples, Italy
4
Radiology Unit, PO Ospedale del Mare, ASL NA1, via Enrico Russo, 80147 Naples, Italy
5
Division of Radiology, “Istituto Nazionale Tumori IRCCS Fondazione Pascale—IRCCS di Napoli”, I-80131 Naples, Italy
6
Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Franco M. Buonaguro
J. Pers. Med. 2021, 11(4), 285; https://doi.org/10.3390/jpm11040285
Received: 25 March 2021 / Revised: 2 April 2021 / Accepted: 8 April 2021 / Published: 8 April 2021
(This article belongs to the Special Issue Cancer Challenges during COVID-19 Pandemic)
Globally, at the time of writing (20 March 2021), 121.759.109 confirmed COVID-19 cases have been reported to the WHO, including 2.690.731 deaths. Globally, on 18 March 2021, a total of 364.184.603 vaccine doses have been administered. In Italy, 3.306.711 confirmed COVID-19 cases with 103.855 deaths have been reported to WHO. In Italy, on 9 March 2021, a total of 6.634.450 vaccine doses have been administered. On 15 March 2021, Italian Medicines Agency (AIFA) decided to temporarily suspend the use of the AstraZeneca COVID-19 vaccine throughout the country as a precaution, pending the rulings of the European Medicines Agency (EMA). This decision was taken in line with similar measures adopted by other European countries due to the death of vaccinated people. On 18 March 2021, EMA’s safety committee concluded its preliminary review about thromboembolic events in people vaccinated with COVID-19 Vaccine AstraZeneca at its extraordinary meeting, confirming the benefits of the vaccine continue to outweigh the risk of side effects, however, the vaccine may be associated with very rare cases of blood clots associated with thrombocytopenia, i.e., low levels of blood platelets with or without bleeding, including rare cases of cerebral venous thrombosis (CVT). We report the case of a 54-year-old woman who developed disseminated intravascular coagulation (DIC) with multi-district thrombosis 12 days after the AstraZeneca COVID-19 vaccine administration. A brain computed tomography (CT) scan showed multiple subacute intra-axial hemorrhages in atypical locations, including the right frontal and the temporal lobes. A plain old balloon angioplasty (POBA) of the right coronary artery was performed, without stent implantation, with restoration of distal flow, but with persistence of extensive thrombosis of the vessel. A successive thorax angio-CT added the findings of multiple contrast filling defects with multi-vessel involvement: at the level of the left upper lobe segmental branches, of left interlobar artery, of the right middle lobe segmental branches and of the right interlobar artery. A brain magnetic resonance imaging (MRI) in the same day showed the presence of an acute basilar thrombosis associated with the superior sagittal sinus thrombosis. An abdomen angio-CT showed filling defects at the level of left portal branch and at the level of right suprahepatic vein. Bilaterally, it was adrenal hemorrhage and blood in the pelvis. An evaluation of coagulation factors did not show genetic alterations so as the nasopharyngeal swab ruled out a COVID-19 infection. The patient died after 5 days of hospitalization in intensive care. View Full-Text
Keywords: COVID-19; cerebral venous thrombosis; intravascular coagulation; vaccine COVID-19; cerebral venous thrombosis; intravascular coagulation; vaccine
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MDPI and ACS Style

D’Agostino, V.; Caranci, F.; Negro, A.; Piscitelli, V.; Tuccillo, B.; Fasano, F.; Sirabella, G.; Marano, I.; Granata, V.; Grassi, R.; Pupo, D.; Grassi, R. A Rare Case of Cerebral Venous Thrombosis and Disseminated Intravascular Coagulation Temporally Associated to the COVID-19 Vaccine Administration. J. Pers. Med. 2021, 11, 285. https://doi.org/10.3390/jpm11040285

AMA Style

D’Agostino V, Caranci F, Negro A, Piscitelli V, Tuccillo B, Fasano F, Sirabella G, Marano I, Granata V, Grassi R, Pupo D, Grassi R. A Rare Case of Cerebral Venous Thrombosis and Disseminated Intravascular Coagulation Temporally Associated to the COVID-19 Vaccine Administration. Journal of Personalized Medicine. 2021; 11(4):285. https://doi.org/10.3390/jpm11040285

Chicago/Turabian Style

D’Agostino, Vincenzo, Ferdinando Caranci, Alberto Negro, Valeria Piscitelli, Bernardino Tuccillo, Fabrizio Fasano, Giovanni Sirabella, Ines Marano, Vincenza Granata, Roberta Grassi, Davide Pupo, and Roberto Grassi. 2021. "A Rare Case of Cerebral Venous Thrombosis and Disseminated Intravascular Coagulation Temporally Associated to the COVID-19 Vaccine Administration" Journal of Personalized Medicine 11, no. 4: 285. https://doi.org/10.3390/jpm11040285

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