A novel scoring system has been developed that can predict mortality in patients with thrombosis with thrombocytopenia syndrome (TTS) after vaccination with the AstraZeneca COVID-19 vaccine [AZD 1222; ChAdOx1-S], say authors of a systematic review published in the European Heart Journal.
Embase, PubMed, Scopus and Web of Science databases were searched for published articles on manifestations and outcomes in patients with TTS after ChAdOx1-S vaccination, and prognostic factors that were predictive of mortality in these patients were investigated.
In total, six case series and 13 case reports in a total of 64 patients were reviewed.
Factors significantly associated with death in patients with TTS included fibrinogen levels (<150 mg/dL), age (≤60 years), platelet count (<25 × 103/µL), intracerebral haemorrhage (ICH) and cerebral venous thrombosis (CVT). This five predictors (1 point each) were included in the fibrinogen, age, platelet count, ICH and CVT (FAPIC) scoring system for predicting mortality in patients with TTS. The predicted mortality rate was 2.08%, 6.66%, 19.31%, 44.54%, 72.94% and 90.05% in patients with FAPIC scores of 0, 1, 2, 3, 4 and 5, respectively.
The FAPIC scoring model was validated in patients with TTS after vaccination with the Janssen COVID-19 vaccine [Ad26.COV2-S].
"The results of our study suggest that a combination of demographic, laboratory, and clinical markers may serve as predictors for mortality in TTS patients and aid identification of high-risk patients in the clinical setting," said the authors.
Reference
- Hwang J, et al. Predictors of mortality in thrombotic thrombocytopenia after adenoviral COVID-19 vaccination: the FAPIC score. European Heart Journal : 12 Sep 2021. Available from: URL: 10.1093/eurheartj/ehab592 [DOI] [PMC free article] [PubMed]