J Thromb Haemost. 2021 Oct 25. doi: 10.1111/jth.15572. Online ahead of print.
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but severe immunological reaction to the non-replicable adenoviral vector-based COVID-19 vaccines. Extreme activation of platelets and the coagulation system leads to a high risk of death from venous or arterial thrombosis or secondary haemorrhage. Public and clinician awareness has reduced mortality of VITT by nearly 90%. The WHO has provided a guideline in July 2021 on diagnosis and management of VITT (also named TTS). Since July 2021 new, clinically relevant information became available. This update has been summarized by the authors in an informal process with recommendations for low resource environments. We provide new available evidence on VITT to empower clinicians to recognize VITT early, then effectively diagnose and treat the disorder to reduce morbidity and mortality. We strongly encourage production of clear management pathways for primary care settings and hospital settings.