{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T15:30:58Z","timestamp":1774539058409,"version":"3.50.1"},"reference-count":86,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>In late February 2021, a prothrombotic syndrome was encountered for the first time in some of the recipients of ChAdOx1 CoV\u201019 vaccine (AstraZeneca, University of Oxford, and Serum Institute of India). Since the hallmark of this syndrome is the development of thrombocytopenia and\/or thrombosis between 4 and 42\u2009days after receiving a COVID\u201019 vaccine, it was named vaccine\u2010induced immune thrombotic thrombocytopenia (VITT). Other names include \u201cvaccine\u2010induced prothrombotic immune thrombocytopenia\u201d and \u201cthrombosis with thrombocytopenia syndrome\u201d by the Centers for Disease Control and the Food and Drug Administration (FDA). VITT appears similar to heparin\u2010induced thrombocytopenia in that \u201cplatelet activating\u201d autoantibodies are produced in both these conditions due to prior exposure of COVID\u201019 vaccine and heparin respectively, in turn causing thrombotic complications and consumptive thrombocytopenia. In this article, recent advances in the understanding of pathobiology, clinical features, investigative work\u2010up, and management of VITT are reviewed.<\/jats:p>","DOI":"10.1111\/ejh.13855","type":"journal-article","created":{"date-parts":[[2022,8,28]],"date-time":"2022-08-28T12:19:02Z","timestamp":1661689142000},"page":"619-632","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["<scp>COVID<\/scp>\u201019: Vaccine\u2010induced immune thrombotic thrombocytopenia"],"prefix":"10.1111","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3028-2518","authenticated-orcid":false,"given":"Fazal\u2010i\u2010Akbar","family":"Danish","sequence":"first","affiliation":[{"name":"Yeovil District Hospital  Yeovil Somerset UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4462-2998","authenticated-orcid":false,"given":"Ahmad Ehsan","family":"Rabani","sequence":"additional","affiliation":[{"name":"HBS Medical and Dental College  Islamabad Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8984-1057","authenticated-orcid":false,"given":"Fazal\u2010e\u2010Rabi","family":"Subhani","sequence":"additional","affiliation":[{"name":"Paediatrics The Rotunda Hospital  Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9751-091X","authenticated-orcid":false,"given":"Saeeda","family":"Yasmin","sequence":"additional","affiliation":[{"name":"Shifa Tameer\u2010e\u2010Millat University  Islamabad Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9138-5107","authenticated-orcid":false,"given":"Salman Shafi","family":"Koul","sequence":"additional","affiliation":[{"name":"Pakistan Institute of Medical Sciences  Islamabad Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.7326\/M21\u20102680"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.7326\/L21\u20100244"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2104882"},{"key":"e_1_2_7_5_1","unstructured":"ShimabukuroT CovidC.Thrombosis with thrombocytopenia syndrome (TTS) following Janssen COVID\u201019 vaccine.40."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107051"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2109908"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2104840"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102005\u201011\u2010012450"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021013231"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.0000238350.89477.88"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2021.05.018"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102013\u201001\u2010478966"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood\u20102013\u201005\u2010504126"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.abl8213"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021014214"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2112760"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines9111344"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2022.03.002"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2022.02.005"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-021-03744-4"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021011958"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2021.280366"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021014588"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200104263441704"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26488"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2105385"},{"key":"e_1_2_7_28_1","unstructured":"COVID\u201019 rapid guideline: vaccine\u2010induced immune thrombocytopenia and thrombosis (VITT)||introduction. Accessed December 30 2021.https:\/\/app.magicapp.org\/#\/guideline\/nYP2ZL\/section\/Lrbr8L"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.7517"},{"key":"e_1_2_7_30_1","unstructured":"Overview | COVID\u201019 rapid guideline: vaccine\u2010induced immune thrombocytopenia and thrombosis (VITT) | guidance | NICE. Accessed October 28 2021.https:\/\/www.nice.org.uk\/guidance\/ng200"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000117571.76197.26"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10072\u2010004\u20100287\u20103"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)00872\u20102"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20101585\u20106182"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2021.279075"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.53.7.1537"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra042354"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1159\/000070129"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(96)07294\u20107"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2004.056275"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.107.487363"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1159\/000047635"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000177894.05495.54"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e31820a8364"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2112974"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15362"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2106383"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2105869"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021012064"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.26237"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1101\/2021.09.23.21263047"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15352"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021012217"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021012479"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe2106315"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2019.1636645"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20101469\u20107481"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2009.06.006"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2021.103174"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2109465"},{"key":"e_1_2_7_61_1","unstructured":"Recommendations of the National Comprehensive Cancer Network\u00ae (NCCN\u00ae) Advisory Committee on COVID\u201019 Vaccination and Pre\u2010exposure Prophylaxis. Accessed December 23 2021.https:\/\/www.nccn.org\/docs\/default-source\/covid-19\/2021_covid-19_vaccination_guidance_v4-0.pdf?sfvrsn=b483da2b_70"},{"key":"e_1_2_7_62_1","unstructured":"Interim Clinical Considerations for Use of COVID\u201019 Vaccines | CDC.2022.https:\/\/www.cdc.gov\/vaccines\/covid-19\/clinical-considerations\/covid-19-vaccines-us.html"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2115926"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2201570"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2203965"},{"key":"e_1_2_7_66_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2119451"},{"key":"e_1_2_7_67_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2200797"},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj\u20102021\u2010069761"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591\u2010022\u201001753\u2010y"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7104e3"},{"key":"e_1_2_7_71_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.0470"},{"key":"e_1_2_7_72_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(21)02844\u20100"},{"key":"e_1_2_7_73_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2119358"},{"key":"e_1_2_7_74_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2021.12.033"},{"key":"e_1_2_7_75_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.abq0203"},{"key":"e_1_2_7_76_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2206725"},{"key":"e_1_2_7_77_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2206576"},{"key":"e_1_2_7_78_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586\u2010022\u201005053\u2010w"},{"key":"e_1_2_7_79_1","unstructured":"Pfizer and BioNTech announce Omicron\u2010adapted COVID\u201019 vaccine candidates demonstrate high immune response against Omicron | Pfizer. Accessed July 31 2022.https:\/\/www.pfizer.com\/news\/press-release\/press-release-detail\/pfizer-and-biontech-announce-omicron-adapted-covid-19"},{"key":"e_1_2_7_80_1","unstructured":"Moderna announces bivalent booster mRNA\u20101273.214 demonstrates potent neutralizing antibody response against Omicron subvariants BA.4 and BA.5. Accessed July 31 2022.https:\/\/investors.modernatx.com\/news\/news\u2010details\/2022\/Moderna\u2010Announces\u2010Bivalent\u2010Booster\u2010mRNA\u20101273.214\u2010Demonstrates\u2010Potent\u2010Neutralizing\u2010Antibody\u2010Response\u2010Against\u2010Omicron\u2010Subvariants\u2010BA.4\u2010And\u2010BA.5\/default.aspx"},{"key":"e_1_2_7_81_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7107e1"},{"key":"e_1_2_7_82_1","unstructured":"COVID\u201019 vaccine training modules.2018. Accessed July 31 2022.https:\/\/www2.cdc.gov\/vaccines\/ed\/covid19\/index.asp"},{"key":"e_1_2_7_83_1","unstructured":"Emergency Use Authorization of Janssen COVID\u201019 Vaccine. Accessed July 31 2022.https:\/\/www.fda.gov\/media\/154870\/download"},{"key":"e_1_2_7_84_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(09)61208\u20103"},{"key":"e_1_2_7_85_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0098175"},{"key":"e_1_2_7_86_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.06.001"},{"key":"e_1_2_7_87_1","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12439"}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.13855","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ejh.13855","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.13855","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,19]],"date-time":"2023-08-19T11:22:39Z","timestamp":1692444159000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ejh.13855"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,30]]},"references-count":86,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1111\/ejh.13855"],"URL":"https:\/\/doi.org\/10.1111\/ejh.13855","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,30]]},"assertion":[{"value":"2022-05-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-22","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}