Research Alert

US Case Reports of Cerebral Venous Sinus Thrombosis With Thrombocytopenia After Ad26.COV2.S Vaccination, March 2 to April 21, 2021

Key Points

Question  What were the clinical characteristics of the first US patients reported to have cerebral venous sinus thrombosis (CVST) with thrombocytopenia following receipt of the Ad26.COV2.S (Janssen/Johnson & Johnson) COVID-19 vaccine?

Findings  In this case series of 12 patients, all were women, younger than 60 years, and had symptom onset ranging from 6 to 15 days after vaccination requiring hospitalization. Of 11 patients with heparin-platelet factor 4 enzyme-linked immunosorbent assay (ELISA) heparin-induced thrombocytopenia (HIT) antibody test results, all were positive. At last follow-up, outcomes were death (n = 3), intensive care unit (ICU) care (n = 3), non-ICU hospitalization (n = 2), and discharge to home (n = 4).

Meaning  This case series may inform clinical guidance and investigations into the potential relationship between the Ad26.COV2.S vaccine and CVST with thrombocytopenia.

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Journal Link: JAMA