Minimal risks for vaccinated

The most recent statistics say that every year in Italy about 60 thousand new cases of thrombosis occur a year, or 1,150 per week, 166 per day. The chances of developing a thrombotic event concern one in every thousand people in the general population, but the risk rises in the elderly (over 70, one in 100) and falls in younger people (one in 10 thousand in under 40s). to a greater danger? “As regards the Astrazeneca vaccine, among other things, the EMA is also evaluating the reports of thromboembolic events, which have also been recorded in people vaccinated with Pfizer – explains Sergio Siragusa, vice president of Sie and among the leading Italian experts on thrombosis -. The numbers in Europe report fewer than 50 cases of thromboembolic events (including deep vein thrombosis and pulmonary embolism) in 17 million vaccinated people, or a risk of 0.000003%. In short, the danger of adverse thromboembolic events in those who are vaccinated is infinitely low, lower than in “normal daily life” and certainly enormously lower than in those who fall ill with Covid and risk dying from venous thromboembolism caused by the infection. . This is why it is essential to protect yourself from Covid-19 and get vaccinated ».

The sure link between Covid and thrombosis

Pulmonary embolism is one of the most serious and feared complications of Covid-19, causing approximately 15% of all deaths from SARS-CoV2 infection. “In fact, all the protocols for Covid treatment provide that the sick be administered heparin – underlines Siragusa, who is director of Hematology at the Palermo Polyclinic -. Pulmonary embolism is the most serious complication of a deep vein thrombosis, which forms in a vein, legs, arms, abdomen, anywhere in the body. Venous thrombosis and pulmonary embolism are closely linked: when a thrombus forms in a vein, it releases fragments that become emboli that reach the lung and cause the so-called pulmonary thromboembolism. “All viruses, and Covid-19 is no exception, trigger in the whole organism a more or less violent inflammatory reaction in the affected organ. Whenever an infection or inflammatory process develops, the blood participates in the battle for healing, increasing its tendency to clot, but very often it forms thrombi in the arteries and veins, anywhere in the body, causing very serious complications that contribute upon death of the patient. The patient attacked by the virus has a fever, is bedridden, is poor in oxygen because the lungs, inflamed by pneumonia, do not work. Meanwhile, the right side of the heart tries to push the blood in the lung to oxygenate, but finds resistance in a reduced pulmonary hydraulic system, occupied by emboli, and with the effort it dilates, loses efficiency, decompensates, goes into arrhythmia. Thus the patient can lose his life.

Who risks more

The causes that predispose to venous thromboembolism are genetic such as thrombophilic or transient mutations (e.g. surgery, hospitalization, bed rest and fever, pregnancy, childbirth, hormonal therapies, tumors, chemotherapy). Pneumonia and chronic obstructive pulmonary disease (COPD) and some inherited types of anemia such as sickle cell anemia also carry a particularly increased risk of pulmonary embolism. Do these people, who are more at risk of venous thromboembolism, face greater dangers if they get vaccinated? “No, on the contrary – says vice president Sie -: not only is the vaccine not contraindicated, but those who are more at risk of thrombosis must all the more fear of getting sick with Covid, because they are more likely to develop the worst consequences of the virus,” such as pulmonary thromboembolism “. And who is already at risk of thrombosis could not do specific tests before getting vaccinated or taking preventive heparin? «Absolutely not – replies the expert -. In fact, at the present time there is no demonstrated correlation between vaccination and thrombotic events; moreover, we do not have tests that allow us to easily identify the individual thrombotic risk. Furthermore, again due to the lack of data on the thrombotic risk of vaccines, it would not be safe to administer heparin to subjects to be vaccinated. Heparin prophylaxis is in fact indicated only in the categories of patients in which it is certainly demonstrated that the advantage of the drug (antithrombotic) outweighs its bleeding risk. In fact, we must not forget that heparin (like all antithrombotic drugs) thins the blood: therefore it is right to run a potential bleeding risk only if the thrombotic risk is higher than it. Which in fact does not exist during vaccination, in which the use of heparin on a large scale would lead to an increase in bleeding ».

What causes thrombosis

“According to our survey, only one countryman three knows what thrombosis is and even fewer are those who are informed that it can be prevented – explains Lidia Rota Vender, specialist in Hematology and Cardiovascular Diseases from Thrombosis and president of ALT Association for the Fight against Thrombosis and to Cardiovascular Diseases -. Thrombosis is a phenomenon caused by an excess tendency of the blood to clot: it can be genetically determined, in those who know they have a personal or family thrombophilic structure, or transient, that is linked to climatic situations, to acute or chronic inflammatory diseases (such as pneumonia, cystitis, irritable bowel, kidney or gallbladder stones) or rheumatic diseases ». Thrombosis can occur in the arteries, causing stroke, myocardial infarction, limb ischemia which can have devastating consequences such as amputation of the affected limb. Or in the superficial or deep veins, causing phlebitis or thrombophlebitis or deep vein thrombosis which unfortunately very often releases emboli that reach the lung causing pulmonary embolism.

Watch out for these symptoms

The signs and symptoms of deep vein thrombosis are subtle and mostly exchangeable with simple stagnation of fluids. “In our country – concludes Lidia Rota Vender – thrombosis diseases, as a whole classified as cardio and cerebrovascular, affect twice as many tumors, are the leading cause of death and serious disability in the population over the age of 65, but they can be avoided in at least one out of three cases. Out of 100 people who lose their lives today 44 have been affected by thrombosis diseases, but too few still know or underestimate it, yet it can have very serious and disabling consequences. When a limb suddenly appears edematous and heavy, it is advisable not to waste time. The specialist clinical evaluation in these cases is not enough: it is essential to undergo an EcoColorDoppler examination, a fast and non-invasive ultrasound check that immediately allows us to see if the veins in our legs have obstructions. Learning to recognize the warning symptoms of thrombosis without underestimating them means decreasing the probability of an unpleasant event in everyday life ».

March 17, 2021 (change March 17, 2021 | 10:06 am)

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