Risk of thrombocytopenic, haemorrhagic and thromboembolic disorders following COVID-19 vaccination and positive test: a self-controlled case series analysis in Wales

Torabi, Fatemeh, Bedston, Stuart, Lowthian, Emily, Akbari, Ashley, Owen, Rhiannon K., Bradley, Declan T., Agrawal, Utkarsh, Collins, Peter ORCID: https://orcid.org/0000-0002-6410-1324, Fry, Richard, Griffiths, Lucy J., Beggs, Jillian, Davies, Gareth, Hollinghurst, Joe, Lyons, Jane, Abbasizanjani, Hoda, Cottrell, Simon, Perry, Malorie, Roberts, Richard, Azcoaga-Lorenzo, Amaya, Fagbamigbe, Adeniyi Francis, Shi, Ting, Tsang, Ruby S. M., Robertson, Chris, Hobbs, F. D. Richard, de Lusignan, Simon, McCowan, Colin, Gravenor, Michael, Simpson, Colin R., Sheikh, Aziz and Lyons, Ronan A. 2022. Risk of thrombocytopenic, haemorrhagic and thromboembolic disorders following COVID-19 vaccination and positive test: a self-controlled case series analysis in Wales. Scientific Reports 12 , 16406. 10.1038/s41598-022-20118-6

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Abstract

There is a need for better understanding of the risk of thrombocytopenic, haemorrhagic, thromboembolic disorders following first, second and booster vaccination doses and testing positive for SARS-CoV-2. Self-controlled cases series analysis of 2.1 million linked patient records in Wales between 7th December 2020 and 31st December 2021. Outcomes were the first diagnosis of thrombocytopenic, haemorrhagic and thromboembolic events in primary or secondary care datasets, exposure was defined as 0–28 days post-vaccination or a positive reverse transcription polymerase chain reaction test for SARS-CoV-2. 36,136 individuals experienced either a thrombocytopenic, haemorrhagic or thromboembolic event during the study period. Relative to baseline, our observations show greater risk of outcomes in the periods post-first dose of BNT162b2 for haemorrhagic (IRR 1.47, 95%CI: 1.04–2.08) and idiopathic thrombocytopenic purpura (IRR 2.80, 95%CI: 1.21–6.49) events; post-second dose of ChAdOx1 for arterial thrombosis (IRR 1.14, 95%CI: 1.01–1.29); post-booster greater risk of venous thromboembolic (VTE) (IRR-Moderna 3.62, 95%CI: 0.99–13.17) (IRR-BNT162b2 1.39, 95%CI: 1.04–1.87) and arterial thrombosis (IRR-Moderna 3.14, 95%CI: 1.14–8.64) (IRR-BNT162b2 1.34, 95%CI: 1.15–1.58). Similarly, post SARS-CoV-2 infection the risk was increased for haemorrhagic (IRR 1.49, 95%CI: 1.15–1.92), VTE (IRR 5.63, 95%CI: 4.91, 6.4), arterial thrombosis (IRR 2.46, 95%CI: 2.22–2.71). We found that there was a measurable risk of thrombocytopenic, haemorrhagic, thromboembolic events after COVID-19 vaccination and infection.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Additional Information:	License information from Publisher: LICENSE 1: URL: http://creativecommons.org/licenses/by/4.0/, Type: open-access
Publisher:	Nature Research
Date of First Compliant Deposit:	3 October 2022
Date of Acceptance:	8 September 2022
Last Modified:	11 Oct 2023 19:45
URI:	https://orca.cardiff.ac.uk/id/eprint/153025

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