Stroke after SARS-CoV-2 vaccination: Comment

Dear Editor, we would like to share ideas on the publication “Stroke seven hours after SARS-CoV-2 vaccination”.¹ Fiorini et al. noted that an acute, ischemic stroke can occur shortly after a SARS-CoV-2 vaccination. Fiorini et al. mentioned that there are more arguments for than against a causal relationship between vaccination and stroke. Fiorini et al. noted that future anti-SARS-CoV-2 vaccines must become safer for everyone who is vaccinated.¹ We both think that protecting COVID-19 is vital and that more research is required to solve the underlying clinical problem. Immunization and the beginning of clinical diseases may be linked. Immunization and the beginning of clinical diseases may be linked. It can be difficult to determine the specific patho-immuno-pharmacological link due to ignorance. If a clinical condition is suspected to be related to COVID-19 immunization, a few critical aspects must be considered. The first is the possibility of co-morbidity. If dengue sickness and vaccine are delivered together, for example, a clinical state may not be adequately detected.² It is also critical to look for any previous cases of asymptomatic COVID-19.³ A previous COVID-19 pandemic is likely to have influenced the effectiveness and outcomes of the vaccine. The COVID-19 infection may have an impact on clinical outcomes. Without the right laboratory examinations, it may be difficult to completely rule out the consequences of previous asymptomatic illnesses. Genetics is an important supporting factor.⁴ The immune system's reaction to various genetic components may influence how it tackles unpleasant side effects after vaccinations. Understanding how the underlying genetic component affects vaccine efficacy in clinical settings would be really beneficial. Regarding the pathomechanism of the stroke, it is clearly reported that the COVID-19 vaccine might cause an increase in antibody levels, further cause hyperviscosity, and then result in a thrombotic complication.⁵ Last, if the stroke is due to the vaccine, there must be strong evidence to show the increase in blood viscosity after vaccination. The problem might be a pre-vaccination problem. A good example is a recent report on a case of a stroke while waiting for COVID-19 immunization a few minutes before.⁶ This problem must be resolved if more study is to be undertaken. If enough data is collected, researchers may be able to learn more.

References

• ¹
  Fiorini AC, Scorza CA, de Almeida AG, Scorza FA, Finsterer J. Stroke seven hours after SARS-CoV-2 vaccination. Clinics (Sao Paulo). 2023;78:100193.
• ²
  Kebayoon A, Wiwanitkit V. Dengue early effects of inactivated (coronavac) SARS-CoV-2 vaccine on retrobulbar vascular blood flow and retinal vascular density. after COVID-19 vaccination: possible and might be missed. Clin Appl Thromb Hemost. 2021;27:10760296211047229.
• ³
  Joob B, Wiwanitkit V. Letter to the editor: coronavirus disease 2019 (COVID-19), infectivity, and the incubation period. J Prev Med Public Health. 2020;53(2):70.
• ⁴
  Čiučiulkaitė I, Möhlendick B, Thümmler L, Fisenkci N, Elsner C, Dittmer U, et al. GNB3 c.825c>T polymorphism influences T-cell but not antibody response following vaccination with the mRNA-1273 vaccine. Front Genet. 2022;13:932043.
• ⁵
  Joob B, Wiwanitkit V. Expected viscosity after COVID-19 vaccination, hyperviscosity and previous COVID-19. Clin Appl Thromb Hemost. 2021;27:10760296211020833.
• ⁶
  Mungmunpuntipantip R, Wiwanitkit V. Thrombosis after adenovirus-vectored COVID-19 vaccination: a concern on underlying illness. Clin Appl Thromb Hemost. 2021;27:10760296211060446.

Publication Dates

• Publication in this collection
  01 Sept 2023
• Date of issue
  2023

History

• Received
  27 Apr 2023
• Reviewed
  20 June 2023
• Accepted
  22 June 2023