Characteristics of cases of de novo immune thrombocytopenia following COVID-19 vaccination
| Characteristics . | All cases (n = 106) . | BNT162b2 (Pfizer-BioNTech, n = 58) . | ChadOx1-S (AstraZeneca, n = 45) . | mRNA-1273 (Moderna, n = 2) . | Ad26COV2 (Janssen, n =1 ) . |
|---|---|---|---|---|---|
| Median age, y (minimum-maximum) | 67 (16-98) | 68 (16-98) | 69 (22-84) | 51 (26-76) | 97 |
| Women, n (%) | 58 (54.7) | 34 (58.6) | 21 (46.7) | 2 (100) | 1 |
| History of autoimmune disease, n (%) | 19 (17.9)* | 12 (20.7) | 7 (15.6) | 1 (50.0) | No |
| Dose† | |||||
| 1, n (%) | 74 (71.8) | 34 (59.6) | 39 (88.6) | 1 (50.0) | 0 |
| 2, n (%) | 29 (28.1) | 23 (40.3) | 5 (11.4) | 1 (50.0) | 0 |
| Median time to ITP onset, days (minimum-maximum) | 11 (1-40) | 9 (1-35) | 12 (2-40) | 17 (10-24) | 28 |
| Median lowest platelet count, ×109/L (minimum-maximum)‡ | 7 (0-87) | 6 (1-87) | 9 (1-68) | 6.5 (6-7) | 0 |
| Bleeding§ | |||||
| No bleeding, n (%) | 19 (18.6) | 10 (18.2) | 9 (20.5) | 0 | 0 |
| All bleeding, n (%) | 83 (81.4) | 45 (81.8) | 35 (79.5) | 2 (100) | 1 |
| Mouth bullae, n (%) | 23 (22.5) | 17 (30.9) | 6 (13.6) | 0 | 0 |
| Epistaxis, n (%) | 6 (5.9) | 4 (7.3) | 2 (4.5) | 0 | 0 |
| Hemoptysis, n (%) | 1 (1.0) | 0 | 2 (4.5) | 0 | 0 |
| Intracranial, n (%) | 2 (2.0) | 2 (3.6) | 0 | 0 | 0 |
| Evolution and treatmentǁ | |||||
| Spontaneous recovery, n (%) | 11 (12.9) | 9 (17.6) | 4 (12.9) | 0 | 0 |
| Recovery after corticosteroids ± IVIG only, n (%) | 55 (64.7) | 36 (70.6) | 14 (45.2) | 2 (100) | 1 |
| Recovery after need of TPORAs as second-line treatment, n (%) | 9 (10.6) | 3 (5.9) | 6 (19.3) | 0 | 0 |
| Recovery after need of rituximab as second-line treatment, n (%) | 3 (3.5) | 0 | 3 (9.7) | 0 | 0 |
| Recovery after need of dapsone as second-line treatment, n (%) | 1 (1.2) | 0 | 1 (3.3) | 0 | 0 |
| Recovery after TPORAs as first-line treatment, n (%) | 1 (1.2) | 1 (2.0) | 0 | 0 | 0 |
| Active disease after corticosteroids without further follow-up, n (%) | 5 (5.9) | 2 (3.9) | 3 (9.7) | 0 | 0 |
| Exposure to another dose of vaccine | |||||
| Relapse of ITP, n | 3 | 3 | 0 | 0 | 0 |
| No relapse of ITP, n | 4 | 1 | 3 | 0 | 0 |
| Absence of subsequent exposure to the vaccine, n | 61 | 28 | 29 | 1 | 1 |
| Unknown, n | 38 | 26 | 13 | 1 | 0 |
| Characteristics . | All cases (n = 106) . | BNT162b2 (Pfizer-BioNTech, n = 58) . | ChadOx1-S (AstraZeneca, n = 45) . | mRNA-1273 (Moderna, n = 2) . | Ad26COV2 (Janssen, n =1 ) . |
|---|---|---|---|---|---|
| Median age, y (minimum-maximum) | 67 (16-98) | 68 (16-98) | 69 (22-84) | 51 (26-76) | 97 |
| Women, n (%) | 58 (54.7) | 34 (58.6) | 21 (46.7) | 2 (100) | 1 |
| History of autoimmune disease, n (%) | 19 (17.9)* | 12 (20.7) | 7 (15.6) | 1 (50.0) | No |
| Dose† | |||||
| 1, n (%) | 74 (71.8) | 34 (59.6) | 39 (88.6) | 1 (50.0) | 0 |
| 2, n (%) | 29 (28.1) | 23 (40.3) | 5 (11.4) | 1 (50.0) | 0 |
| Median time to ITP onset, days (minimum-maximum) | 11 (1-40) | 9 (1-35) | 12 (2-40) | 17 (10-24) | 28 |
| Median lowest platelet count, ×109/L (minimum-maximum)‡ | 7 (0-87) | 6 (1-87) | 9 (1-68) | 6.5 (6-7) | 0 |
| Bleeding§ | |||||
| No bleeding, n (%) | 19 (18.6) | 10 (18.2) | 9 (20.5) | 0 | 0 |
| All bleeding, n (%) | 83 (81.4) | 45 (81.8) | 35 (79.5) | 2 (100) | 1 |
| Mouth bullae, n (%) | 23 (22.5) | 17 (30.9) | 6 (13.6) | 0 | 0 |
| Epistaxis, n (%) | 6 (5.9) | 4 (7.3) | 2 (4.5) | 0 | 0 |
| Hemoptysis, n (%) | 1 (1.0) | 0 | 2 (4.5) | 0 | 0 |
| Intracranial, n (%) | 2 (2.0) | 2 (3.6) | 0 | 0 | 0 |
| Evolution and treatmentǁ | |||||
| Spontaneous recovery, n (%) | 11 (12.9) | 9 (17.6) | 4 (12.9) | 0 | 0 |
| Recovery after corticosteroids ± IVIG only, n (%) | 55 (64.7) | 36 (70.6) | 14 (45.2) | 2 (100) | 1 |
| Recovery after need of TPORAs as second-line treatment, n (%) | 9 (10.6) | 3 (5.9) | 6 (19.3) | 0 | 0 |
| Recovery after need of rituximab as second-line treatment, n (%) | 3 (3.5) | 0 | 3 (9.7) | 0 | 0 |
| Recovery after need of dapsone as second-line treatment, n (%) | 1 (1.2) | 0 | 1 (3.3) | 0 | 0 |
| Recovery after TPORAs as first-line treatment, n (%) | 1 (1.2) | 1 (2.0) | 0 | 0 | 0 |
| Active disease after corticosteroids without further follow-up, n (%) | 5 (5.9) | 2 (3.9) | 3 (9.7) | 0 | 0 |
| Exposure to another dose of vaccine | |||||
| Relapse of ITP, n | 3 | 3 | 0 | 0 | 0 |
| No relapse of ITP, n | 4 | 1 | 3 | 0 | 0 |
| Absence of subsequent exposure to the vaccine, n | 61 | 28 | 29 | 1 | 1 |
| Unknown, n | 38 | 26 | 13 | 1 | 0 |
Abbreviations: ITP, immune thrombocytopenia; IVIG, intravenous immunoglobulin; TPORA, thrombopoietin receptor agonist.
5 patients with thyroiditis (including 2 Graves' disease), 2 with thyroiditis + psoriasis, 1 with thyroiditis + rheumatoid arthritis, 1 with systemic lupus erythematosus, 1 with sarcoidosis, 1 with granulomatosis with polyangiitis, 1 with autoimmune hemolytic anemia, 1 with rheumatoid arthritis, 1 with polymyalgia rheumatica, 1 with primary biliary cirrhosis + Biermer anemia, 1 with Behçet disease, 1 with multiple sclerosis, 1 with type 1 diabetes mellitus, and 1 with extramembranous glomerulonephritis.
3 missing values (BNT162b, ChadOx1-S, Ad26COV2, n = 1 each).
1 missing value (with BNT162b).
4 missing values (3 with BNT162b and 1 with ChadOx1-S).
21 missing values (7 with BNT162b and 14 with ChadOx1-S).