{"id":1388,"date":"2021-08-05T18:55:22","date_gmt":"2021-08-05T18:55:22","guid":{"rendered":"http:\/\/wp.cov19longhaulfoundation.org\/?p=1388"},"modified":"2021-08-05T18:55:22","modified_gmt":"2021-08-05T18:55:22","slug":"covid-19-vaccines-induce-severe-hemolysis-in-paroxysmal-nocturnal-hemoglobinuria","status":"publish","type":"post","link":"https:\/\/cov19longhaulfoundation.org\/?p=1388","title":{"rendered":"COVID-19 vaccines induce severe hemolysis in paroxysmal nocturnal hemoglobinuria"},"content":{"rendered":"\n

Authors: Gloria F. Gerber<\/a>,1<\/sup>\u00a0Xuan Yuan<\/a>,1<\/sup>\u00a0Jia Yu<\/a>,1<\/sup>\u00a0Benjamin A.Y. Cher<\/a>,2<\/sup>\u00a0Evan M. Braunstein<\/a>,1<\/sup>\u00a0Shruti Chaturvedi<\/a>,1<\/sup>\u00a0and\u00a0Robert A. Brodsky<\/a>1,*<\/sup><\/p>\n\n\n\n

Complement has emerged as a likely driver of the immune response and end-organ damage in COVID-19. In patients with severe disease, deposition of terminal complement and microthrombosis have been observed in the lung, skin, kidney, and heart.1<\/a><\/sup>, <\/sup>2<\/a><\/sup>, <\/sup>3<\/a><\/sup>, <\/sup>4<\/a><\/sup> Recently, we demonstrated that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein leads to amplification of the alternative pathway of complement on cell surfaces through competition with complement factor H (CFH) for binding heparan sulfate.5<\/a><\/sup> Thus, in vitro, the SARS-CoV-2 spike protein can convert an inactivator surface to an activator surface on nucleated cells.<\/p>\n\n\n\n

Two messenger RNA (mRNA)-based vaccines that lead to transient expression of the SARS-CoV-2 spike protein are highly efficacious in preventing severe infection.6<\/a><\/sup> ,<\/sup> 7<\/a><\/sup> Reactions to these vaccines are generally mild; however, increased complement amplification could theoretically lead to more severe effects in diseases like paroxysmal nocturnal hemoglobinuria (PNH), where blood cells lack complement regulatory proteins.8<\/a><\/sup> Here, we describe significant adverse reactions to COVID-19 vaccines in 4 patients with PNH. We also present 2 patients with PNH who received the vaccine without significant adverse effects or hemolysis.<\/p>\n\n\n\n

Patient characteristics and reactions to the COVID-19 vaccines are shown in\u00a0Table 1<\/a>\u00a0. Patients were identified based on self-report of receiving the vaccine. Patients were aged 25 to 63 years, had PNH granulocyte clones of \u226580%, and had not received transfusions in the past year. Reactions occurred from the day of administration to 5 days later and lasted 1 to 6 days. Four of 6 patients reported fever. Patients 2, 3, and 4 experienced severe hemolysis with 2 to 4 g\/dL hemoglobin decrease. Patient 1 had a presumptive thrombotic manifestation. Patients 5 and 6 received both doses of the Pfizer-BioNTech BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine without clinical or laboratory signs of hemolysis.<\/p>\n\n\n\n

For More Information: https:\/\/pubmed.ncbi.nlm.nih.gov\/33933145\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Authors: Gloria F. Gerber,1\u00a0Xuan Yuan,1\u00a0Jia Yu,1\u00a0Benjamin A.Y. Cher,2\u00a0Evan M. Braunstein,1\u00a0Shruti Chaturvedi,1\u00a0and\u00a0Robert A. Brodsky1,* Complement has emerged as a likely driver of the immune response and end-organ damage in COVID-19. In […]<\/p>\n","protected":false},"author":2,"featured_media":1389,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[978,939,607],"tags":[],"class_list":["post-1388","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-adverse-event-reporting","category-safety-studies","category-vaccine-news"],"_links":{"self":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/1388","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1388"}],"version-history":[{"count":0,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/1388\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/media\/1389"}],"wp:attachment":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1388"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1388"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1388"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}