Cavernous sinus thrombosis in a COVID-19 patient: A case report

Khacha, Anass; Bouchal, Siham; Ettabyaoui, Ayoub; Haloua, Meriem; Lamrani, Youssef Alaοui; Bοubbοu, Meryem; Belahsen, M.F.; Maâroufi, Mustapha; Alami, Badreeddine

doi:10.1016/j.radcr.2020.12.013

Cited by 20 publications

(19 citation statements)

References 12 publications

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“…As previously discussed, the association of CVT with COVID-19 has attracted interest from neurologists. Table 1 summarizes the clinical characteristics of the CVT cases associated with CVT that have been reported [ [21] , [22] , [23] , [24] , [25] , [26] , [27] , 32 , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , [73] , [74] , [75] ]. Hughes et al.…”

Section: Resultsmentioning

confidence: 99%

“…[ 71 ] 43/F – Eight days Levetiracetam, hydroxychloroquine, low molecular weight heparin, oseltamivir and ceftriaxone Improved Khacha et al. [ 72 ] 55/M – A few days Infused heparin and acenocoumarol Improved Mowla et al. [ 73 ] 13 patients – A few days Anticoagulant therapy Six patients discharged with good outcomes and three died Nwajei et al.…”

Section: Resultsmentioning

confidence: 99%

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Cerebral venous thrombosis in COVID-19

Ghosh

Roy

Mandal

et al. 2021

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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Background and aims Initially, novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) was considered primarily a respiratory pathogen. However, with time it has behaved as a virus with the potential to cause multi-system involvement, including neurological manifestations. Cerebral venous sinus thrombosis (CVT) has increasingly been reported in association with coronavirus infectious disease of 2019 (COVID-19). Here, we have shed light upon CVT and its possible mechanisms in the backdrop of the ongoing COVID-19 pandemic. Methods In this review, data were collected from PubMed, EMBASE and Web of Science, until March 30, 2021, using pre-specified searching strategies. The search strategy consisted of a variation of keywords of relevant medical subject headings and keywords, including “COVID-19”, “SARS-CoV-2”, “coronavirus”, and “cerebral venous sinus thrombosis”. Results COVID-19 has a causal association with a plethora of neurological, neuropsychiatric and psychological effects. CVT has gained particular importance in this regard. The known hypercoagulable state in SARS-CoV-2 infection is thought to be the main mechanism in COVID-19 related CVT. Other plausible mechanisms may include vascular endothelial dysfunction and altered flow dynamics. Conclusions Although there are no specific clinical characteristics, insidious or acute onset headache, seizures, stroke-like, or encephalopathy symptoms in a patient with, or who has suffered COVID-19, should prompt the attending physician to investigate for CVT. The treatment of COVID-19 associated CVT does not differ radically from the therapy of CVT without the infection, i.e. urgent initiation of parenteral unfractionated heparin or low molecular weight heparin followed by conventional or mostly newer oral anticoagulants.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Cerebral venous thrombosis in COVID-19

Ghosh

Roy

Mandal

et al. 2021

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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“…An otherwise rare fungal infection, the increase in CAM cases has predisposed patients to multiple presentations of invasive fungal disease. In association with CAM, cavernous sinus thrombosis has only been reported as isolated case studies [3] [4]. However, no studies have studied the risk factors and outcomes in cavernous sinus thrombosis in CAM.…”

Section: Introductionmentioning

confidence: 99%

Cavernous Sinus Thrombosis in COVID-19 Associated Rhino-Orbital Mucormycosis: A Retrospective Audit in the First Wave of the Pandemic

Chowdhary

Alexander

Ganesan

et al. 2021

Preprint

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Purpose Cavernous sinus thrombosis (CST) is a complication of rhino-orbital-cerebral mucormycosis. The COVID-19 pandemic saw a rapid surge in the cases of acute fungal sinusitis, many of whom also had CST, further contributing to the ophthalmoplegia. This study was a retrospective audit of patients with mucormycosis treated during the first wave of the COVID-19 pandemic.Methods This study was conducted at a tertiary referral centre, and patients with rhino-orbital mucormycosis were included. Relevant laboratory investigations and CT scans of the paranasal sinuses and the cavernous sinus were analysed. Mortality at discharge was calculated.Results 61 cases of invasive mucormycosis were seen, of whom 20 were COVID-19 positive, and 21 had radiological evidence of CST. All patients in the study initially presented with clinical suspicion of mucormycosis, and COVID-19 was diagnosed during pre-admission investigations. 93% of patients had diabetes. A majority of patients received Amphotericin B and surgical debridement. The sphenoid sinus was involved in 32(52%) patients and the orbit in 34(56%). Factors affecting CST, such as platelet counts, were studied. Fifteen (25%) patients succumbed during their treatment.Conclusions 34.4% of patients with mucormycosis developed CST. Being COVID-19 positive led to an increase in mortality; however, there was no significant increase in death due to simultaneous COVID-19 and CST. Sinus involvement was not significant for the development of CST.

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“…10 COVID-19 is known to have a hypercoagulable presentation along with increased fibrinogen and D-dimers blood levels. [17][18][19][20] This may lead to an increased incidence of cerebral venous sinus thrombosis (CVST) in such cases. 19,20 Other inflammatory markers may also be higher in patients with ocular symptoms as compared to those without any.…”

Section: Introductionmentioning

confidence: 99%

“…[17][18][19][20] This may lead to an increased incidence of cerebral venous sinus thrombosis (CVST) in such cases. 19,20 Other inflammatory markers may also be higher in patients with ocular symptoms as compared to those without any. 1,3,9,10,[18][19][20][21][22][23][24] Recent studies have reported a new spectacle of this disease spectrum in the form of rhino-orbital mucormycosis.…”

Section: Introductionmentioning

confidence: 99%

Ophthalmic manifestations of SARS-CoV-2 (COVID-19)

Ramachandra¹,

Garg²

2021

IJCEO

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The world has been dealing with the pandemic of COVID-19 since December 2019. The systemic manifestations of the disease are well known. Our study aims to evaluate the ocular manifestations of SARS-CoV-2 (COVID-19). This cross-sectional observational study comprised of 60 subjects that tested positive for COVID-19 by RT-PCR, and admitted to the general wards of a tertiary care hospital of South India. Relevant medical history, ocular history, symptoms, signs and blood investigations data were obtained by communicating directly with the subjects and patient files. Ocular examination was done using diffuse torch light.15% patients presented with conjunctivitis in association with increased conjunctival secretion, tearing and burning sensation. 3.33% patients presented with dry eye disease and orbital cellulitis each. 1.67% patients developed epiphora, cavernous sinus thrombosis and orbital cellulitis with retinal detachment each. A statistically significant correlation was found between the provisional diagnosis and C-reactive protein (CRP) values.Conjunctival congestion can be one of the ocular symptoms of COVID-19. Asymptomatic COVID-19 patients may primarily present to an ophthalmologist with red eye, thus universal precautions must be taken while examining such cases. Evaluation of symptomatic patients with orbital cellulitis and cavernous sinus thrombosis can further aid in understanding the ophthalmic implications, pathogenesis and systemic involvement of this disease.

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Cavernous sinus thrombosis in a COVID-19 patient: A case report

Cited by 20 publications

References 12 publications

Cerebral venous thrombosis in COVID-19

Cerebral venous thrombosis in COVID-19

Cavernous Sinus Thrombosis in COVID-19 Associated Rhino-Orbital Mucormycosis: A Retrospective Audit in the First Wave of the Pandemic

Ophthalmic manifestations of SARS-CoV-2 (COVID-19)

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