Thrombotic Thrombocytopenia Induced by Cov-2 Infection and Some Components of Vaccines: Is it Related to Host Prethrombotic State? - Abstract
CoV-2 infection-induced thrombotic thrombocytopenia purpura [TTP] is life-threatening event often observed amongst critically ill CoV-2 patients and intriguingly subsequent to vaccination, as a rare event, with an incidence about 10 cases per million vaccinated individuals, as characterised by blood clot combined with low platelet count. Nevertheless, it is unclear how vaccines that are not infective and based mainly on the characteristic of the viral spike proteins, could lead selectively to thrombotic event, unless a host predisposition to thrombotic events is already in place. Nevertheless this rare event open the door of Pandora box to a series of other important questions that remains to be fully investigated: i] Why the physiological responses to CoV-2 infection and the vaccine’ spike proteins are age- dependent and appears predominantly occurs in young female below the age 50?; ii] Why the type of blood clot forms by differing infection differs and only severely affects the unvaccinated populations? and how these events should be accurately diagnosed ?; iii] Where we stands on the balance the overall benefit of the vaccination, in building a solid protection barrier against infection versus the negligible rare risk of thrombotic even in certain predisposed groups?. The main objective of this invited commentary is to provide a personal viewpoint on the CoV-2 infection or vaccines- induced TTP and to explore the planed remedial action to survive COVID and to save some lives. While the race between, the emergence of fast spreading mutated virus, versus the limited therapeutic values of slow acting of vaccines therapy continue, the use of some innovative and safer alternative booster therapies for the immediate delivery of some multivariate -targeted neutralising
antibodies is considered to be the best preventative and therapeutic strategies intervention that we do need right now urgently. In short while efforts in developing multivariate types of vaccines are still progressing, but because of the delayed mode of action of passive immunotherapy, taking up to 3-4 weeks to develop real protection against infection, and vaccines effectiveness not being 100%, vigilance is still the key element in the advancement of mass vaccination rollout to survive COVID.