Abstract 112: Cerebral Venous Sinus Thrombosis Due To Vaccine-induced Immune Thrombotic Thrombocytopenia In Middle-Income Countries

Munckhof, Anita van de; Borhani-Haghighi, Afshin; Aaron, Sanjith; Krzywicka, Katarzyna; Poli, Sven; Cordonnier, Charlotte; Kleinig, Timothy; Lemmens, Robin; Kammen, Mayte Sánchez van; Scutelnic, Adrian; Lindgren, Erik; Mbroh, Joshua; Ciccone, Alfonso; Wittstock, Matthias; Zimmermann, Julian; Bode, Felix J; Skjelland, Mona; Devroye, A; Duan, Jiangang; Hiltunen, Sini; Petruzzellis, Marco; Hovinga, Johanna A. Kremer; Günther, Albrecht; Jood, Katarina; Tatlısumak, Turgut; Putaala, Jukka; Heldner, Mirjam R; Arnold, Marcel; Sousa, Diana Aguiar de; Wasay, Muhammad; Araúz, Antonio; Conforto, Adriana Bastos; Ferro, José M.; Coutinho, Jonathan M.

doi:10.1161/str.54.suppl_1.112

Cited by 5 publications

(6 citation statements)

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“…65 Interestingly, a large international registry showed a lower incidence of CVT in middle-income countries along with low mortality despite the predominant use of the adenovirus vaccines as compared to high-income countries. 66 More surprisingly, no cases were reported from low-income countries. 66 This difference may be attributed to misdiagnosis or underdiagnoses of CVT along with the lack of laboratory confirmation in these countries but despite this, we would have expected more cases.…”

Section: Discussionmentioning

confidence: 97%

“…66 More surprisingly, no cases were reported from low-income countries. 66 This difference may be attributed to misdiagnosis or underdiagnoses of CVT along with the lack of laboratory confirmation in these countries but despite this, we would have expected more cases. It is possible that the CVT-vaccine-induced immune thrombotic thrombocytopenia (VITT) risk differs among populations.…”

Section: Discussionmentioning

confidence: 97%

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COVID and Vaccine-related Cerebral Venous Thrombosis

Saleem,

Hameed,

Wasay

2024

Journal of Stroke Medicine

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The coronavirus disease-2019 (COVID-19) pandemic has been a major threat to global health. It primarily affects the respiratory system but multiple organs, including the nervous system, can be affected. Cerebral venous thrombosis (CVT) has been reported among COVID-19 patients as well as among recipients of COVID vaccines. CVT often remains a diagnostic challenge due to highly variable clinical presentation. We underwent a thorough narrative review of the published literature from January 2020 to April 2023 in the Medline (PubMed) database. Our search led to 66 studies in total, 30 related to COVID-CVT and 36 related to COVID vaccine-CVT. We further looked for differences between these COVID-CVT and COVID vaccine-associated-CVT and their possible pathophysiology, treatment options, and prognosis. A few things that were highlighted during our search: COVID increases CVT risk and can happen without respiratory manifestations. COVID-CVT is more common in middle-aged men and has a higher morality compared to traditional non-COVID-CVT. COVID vaccines also increase the risk of CVT but less than the COVID infection. COVID vaccine-CVT is further divided into two groups having either normal platelets or low platelets. The latter group is better reported and has a higher inpatient mortality and disability at discharge but these patients usually recover well in the follow-up period. Non-heparin anticoagulation, immunomodulation, and surgery are the main treatment options.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

COVID and Vaccine-related Cerebral Venous Thrombosis

Saleem,

Hameed,

Wasay

2024

Journal of Stroke Medicine

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“…This proportion is in line with our previous report on outcomes of CVST‐VITT patients in the acute phase of their presentation. At the 5‐month follow‐up, almost 90% had regained functional independence [10, 22, 23]. Nevertheless, due to the limited size of this substudy cohort, these numbers should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

Decompressive surgery in cerebral venous sinus thrombosis due to vaccine‐induced immune thrombotic thrombocytopenia

Krzywicka

Sousa

Cordonnier

et al. 2023

Euro J of Neurology

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Background and purpose Cerebral venous sinus thrombosis due to vaccine‐induced immune thrombotic thrombocytopenia (CVST‐VITT) is an adverse drug reaction occurring after severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccination. CVST‐VITT patients often present with large intracerebral haemorrhages and a high proportion undergoes decompressive surgery. Clinical characteristics, therapeutic management and outcomes of CVST‐VITT patients who underwent decompressive surgery are described and predictors of in‐hospital mortality in these patients are explored. Methods Data from an ongoing international registry of patients who developed CVST within 28 days of SARS‐CoV‐2 vaccination, reported between 29 March 2021 and 10 May 2022, were used. Definite, probable and possible VITT cases, as defined by Pavord et al. (N Engl J Med 2021; 385: 1680–1689), were included. Results Decompressive surgery was performed in 34/128 (27%) patients with CVST‐VITT. In‐hospital mortality was 22/34 (65%) in the surgical and 27/94 (29%) in the non‐surgical group (p < 0.001). In all surgical cases, the cause of death was brain herniation. The highest mortality rates were found amongst patients with preoperative coma (17/18, 94% vs. 4/14, 29% in the non‐comatose; p < 0.001) and bilaterally absent pupillary reflexes (7/7, 100% vs. 6/9, 67% with unilaterally reactive pupil, and 4/11, 36% with bilaterally reactive pupils; p = 0.023). Postoperative imaging revealed worsening of index haemorrhagic lesion in 19 (70%) patients and new haemorrhagic lesions in 16 (59%) patients. At a median follow‐up of 6 months, 8/10 of surgical CVST‐VITT who survived admission were functionally independent. Conclusions Almost two‐thirds of surgical CVST‐VITT patients died during hospital admission. Preoperative coma and bilateral absence of pupillary responses were associated with higher mortality rates. Survivors often achieved functional independence.

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“…The outcome of VST due to VITT also varies considerably between studies. In a retro-spective study of 36 patients with VST due to VITT, the outcome of SC2V-related VST was fatal in up to 40% of cases [12].…”

Section: Venous Sinus Thrombosismentioning

confidence: 99%

Neurological Adverse Reactions to SARS-CoV-2 Vaccines

Finsterer¹

2023

Clin Psychopharmacol Neurosci

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SARS-CoV-2 vaccines are not free of side effects and most commonly affect the central or peripheral nervous system (CNS, PNS). This narrative review aims to summarise recent advances in the nature, frequency, management, and outcome of neurological side effects from SARS-CoV-2 vaccines. CNS disorders triggered by SARS-CoV-2 vaccines include headache, cerebro-vascular disorders (venous sinus thrombosis [VST], ischemic stroke, intracerebral hemorrhage, subarachnoid bleeding, reversible, cerebral vasoconstriction syndrome, vasculitis, pituitary apoplexy, Susac syndrome), inflammatory diseases (encephalitis, meningitis, demyelinating disorders, transverse myelitis), epilepsy, and a number of other rarely reported CNS conditions. PNS disorders related to SARS-CoV-2 vaccines include neuropathy of cranial nerves, mono-/polyradiculitis (Guillain-Barre syndrome [GBS]), Parsonage-Turner syndrome (plexitis), small fiber neuropathy, myasthenia, myositis/dermatomyositis, rhabdomyolysis, and a number of other conditions. The most common neurological side effects are facial palsy, intracerebral hemorrhage, VST, and GBS. The underlying pathophysiology is poorly understood, but several speculations have been generated to explain the development of CNS/PNS disease after SARS-CoV-2 vaccination. In conclusion, neurological side effects develop with any type of SARS-CoV-2 vaccine and are diverse, can be serious and even fatal, and should be taken seriously to initiate early treatment and improve outcome and avoid fatalities. KEY WORDS: Side effects; COVID-19 vaccination; Neurological; Brain; Nerves."venous sinus thrombosis", "multiple sclerosis", "acute disseminated encephalomyelitis", "seizure", "Guillain Barre syndrome", "Parsonage Turner syndrome", "myositis", and "myasthenia". In addition, reference lists were searched for additional articles that matched the search criteria. Neurological COVID Vaccination Complications 223Table 1. Most common marketed anti-SARS-CoV-2 vaccines Company Generic name Brand name Ⓡ Technology Number of dosages Biontech Pfizer BNT162b2 Comirnaty m-RNA Two/booster Moderna m-RNA1273 Spikevax m-RNA Two/booster Astra Zeneca ChAdOx1-S nCoV-19 Vaxzevira Viral vector Two/booster Curevac CVnCoV Zorecimeran m-RNA Two Novavax NVX-Cov2373 Novaxovid Protein subunit Two Johnson & Johnson Ad26.COV.2S Jcovden Viral vector One Sinovac CoronaVac CoronaVac Viral vector Two/booster Valneva VLA2001 COVID-19 vaccine Viral vector Two/booster Sinopharm COVID 2019 vaccine BIBP Viral vector Two/booster Gam-Covid-Vac Sputnik-V Gam-Covid-Vac Viral vector Two Bharat Biotech BBV152 Covaxin Viral vector Two/booster CanSino Biologics Ad5-nCoV Convidecia Viral vector Single Sinopharm BBIBP32-CorV Covilo Viral vector Two booster Sanofi Pasteur VidPrevtyn beta VidPrevtyn beta Protein subunit OneOriginal articles and reviews published between 1966 and December 2022 were included. Abstracts, proceedings, and editorials were excluded from data analysis. The review does not claim to be complete, since the number of words and references was...

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Abstract 112: Cerebral Venous Sinus Thrombosis Due To Vaccine-induced Immune Thrombotic Thrombocytopenia In Middle-Income Countries

Cited by 5 publications

References 0 publications

COVID and Vaccine-related Cerebral Venous Thrombosis

COVID and Vaccine-related Cerebral Venous Thrombosis

Decompressive surgery in cerebral venous sinus thrombosis due to vaccine‐induced immune thrombotic thrombocytopenia

Neurological Adverse Reactions to SARS-CoV-2 Vaccines

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