Cerebral venous thrombosis in a young asymptomatic COVID-19 patient

Dias, Rafael; Soares-dos-Reis, Ricardo; Sousa, Sara Pereira de; Rocha, Ana Filipa; Ribeiro, Ana Margarida; Alméida, J. Sánchez

doi:10.1097/j.pbj.0000000000000165

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…16 The median time duration from COVID infection to CVT diagnosis reported is seven days (range 1–120 days). 9, 35–39 The largest multicentric observational study published consisting of 20 patients also reported a male predominance (70%) and a mean age of 42.4 years at the time of presentation. 9 Traditionally, non-COVID-CVT is more common in young females (59%–75%), mostly in their second and third decades of life.…”

Section: Discussionmentioning

confidence: 98%

“…Among the published case reports, the majority of COVID-CVT cases are middle-aged to elderly males. Traditional CVT-related risk factors were absent 17,[28][29][30][31][32][33][34][35][36] except for two cases having OCPs 16,37 with one also being obese. 16 The median time duration from COVID infection to CVT diagnosis reported is seven days (range 1-120 days).…”

Section: Covid-cvtmentioning

confidence: 94%

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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: 98%

Section: Covid-cvtmentioning

confidence: 94%

COVID and Vaccine-related Cerebral Venous Thrombosis

Saleem,

Hameed,

Wasay

2024

Journal of Stroke Medicine

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“…Compared with other serious neurological events, CVST potentially associated with COVID-19 vaccination has the greatest amount of high-grade evidence ( Table 7 ). 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 Across 9 case reports detailing 23 cases, CVST was described mostly in patients 60 years and younger (20/23; 87%) and predominantly occurred in females (19/23; 782%). The most frequent presenting symptoms included headache, motor deficits, and myalgias.…”

Section: Cerebral Venous Sinus Thrombosismentioning

confidence: 99%

Neurological Considerations with COVID-19 Vaccinations

et al. 2023

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The benefits of coronavirus disease 2019 (COVID-19) vaccination significantly outweigh its risks on a public health scale, and vaccination has been crucial in controlling the spread of SARS-CoV-2. Nonetheless, several reports of adverse events following vaccination have been published.To summarize reports to date and assess the extent and quality of evidence regarding possible serious adverse neurological events following COVID-19 vaccination, focusing on Food and Drug Administration (FDA)-approved vaccines in the United States (BNT162b2, mRNA-1273, and Ad26.COV2.S).A review of literature from five major electronic databases (PubMed, Medline, Embase, Cochrane Library, and Google Scholar) was conducted between December 1, 2020 and June 5, 2022. Articles included in the review were systematic reviews and meta-analysis, cohort studies, retrospective studies, case–control studies, case series, and reports. Editorials, letters, and animal studies were excluded, since these studies did not include quantitative data regarding adverse side effects of vaccination in human subjects.Of 149 total articles and 97 (65%) were case reports or case series. Three phase 3 trials initially conducted for BNT162b2, MRNA-1273, and Ad26.COV2.S were included in the analysis.The amount and quality of evidence for possible neurological adverse events in the context of FDA-approved COVID-19 vaccinations is overall low tier. The current body of evidence continues to suggest that COVID-19 vaccinations have a high neurological safety profile; however, the risks and benefits of vaccination must continue to be closely monitored.

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Characteristics and outcomes of cerebral venous thrombosis associated with COVID-19

Scutelnic,

van de Munckhof,

Miraclin

et al. 2024

European Stroke Journal

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Introduction: Previous reports and meta-analyses derived from small case series reported a mortality rate of up to 40% in patients with coronavirus disease 2019 associated cerebral venous thrombosis (COVID-CVT). We assessed the clinical characteristics and outcomes in an international cohort of patients with COVID-CVT. Patients and methods: This was a registry study of consecutive COVID-CVT patients diagnosed between March 2020 and March 2023. Data collected by the International Cerebral Venous Thrombosis Consortium from patients with CVT diagnosed between 2017 and 2018 served as a comparison. Outcome analyses were adjusted for age and sex. Results: We included 70 patients with COVID-CVT from 23 hospitals in 15 countries and 206 controls from 14 hospitals in 13 countries. The proportion of women was smaller in the COVID-CVT group (50% vs 68%, p < 0.01). A higher proportion of COVID-CVT patients presented with altered mental state (44% vs 25%, p < 0.01), the median thrombus load was higher in COVID-CVT patients (3 [IQR 2–4] vs 2 [1–3], p < 0.01) and the length of hospital stay was longer compared to controls (11 days [IQR 7–20] vs 8 [4–15], p = 0.02). In-hospital mortality did not differ (5/67 [7%, 95% CI 3–16] vs 7/206 [3%, 2–7], aOR 2.6 [95% CI 0.7–9]), nor did the frequency of functional independence after 6 months (modified Rankin Scale 0–2; 45/58 [78%, 95% CI 65–86] vs 161/185 [87%, 81–91], aOR 0.5 [95% CI 0.2–1.02]). Conclusion: In contrast to previous studies, the in-hospital mortality rate and functional outcomes during follow-up did not differ between COVID-CVT patients and the pre-COVID-19 controls.

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Cerebral venous thrombosis in a young asymptomatic COVID-19 patient

Cited by 3 publications

References 5 publications

COVID and Vaccine-related Cerebral Venous Thrombosis

COVID and Vaccine-related Cerebral Venous Thrombosis

Neurological Considerations with COVID-19 Vaccinations

Characteristics and outcomes of cerebral venous thrombosis associated with COVID-19

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