COVID-19 as triggering co-factor for cortical cerebral venous thrombosis?

Baudar, Coline; Duprez, Thierry; Kassab, Amandine; Miller, Nathalie; Rutgers, Matthieu Pierre

doi:10.1016/j.neurad.2020.06.008

Cited by 22 publications

(35 citation statements)

References 12 publications

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“…IS and CVST could have a common pathophysiological path in the inflammatory and pro-coagulant state correlated with COVID-19 and is supported from the biochemical point of view by the significantly increased values of D-dimer. In some cases of CVST, however, COVID-19 infection is explicitly reported as a possible etiological cofactor in association with known risk conditions, such as taking estrogenprogestin therapy (73,128). Moreover, the presence of known previous risk factors for stroke (e.g., AH, AF, vascular disease, DLP, smoking) is common in reported cases of IS, but there are also reports among patients with no known risk factors (26.4%, Supplementary Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Fourteen cases of CVST in patients with COVID-19 were reported in the literature (50% males, mean age: 42.8 years ± 15.47; median: 49; range: 23-72 years) ( Table 3, Supplementary Table 3) (28,39,(122)(123)(124)(125)(126)(127)(128)(129)(130). Seven patients did not have any known risk factors for CVST, three patients had obesity, two patients had DM, and one patient suffered from smoking and drinking consumption or a history of breast cancer in remission.…”

Section: Cerebral Venous Sinus Thrombosismentioning

confidence: 99%

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COVID-19 and Cerebrovascular Diseases: A Systematic Review and Perspectives for Stroke Management

et al. 2020

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Importance: Reported cerebrovascular events in patients with COVID-19 are mainly ischemic, but hemorrhagic strokes and cerebral venous sinus thrombosis (CSVT), especially in critically ill patients, have also been described. To date, it is still not clear whether cerebrovascular manifestations are caused by direct viral action or indirect action mediated by inflammatory hyperactivation, and in some cases, the association may be casual rather than causal. Objective: To conduct a systematic review on the cerebrovascular events in COVID-19 infection. Evidence review: A comprehensive literature search on PubMed was performed including articles published from January 1, 2020, to July 23, 2020, using a suitable keyword strategy. Additional sources were added by the authors by reviewing related references. The systematic review was conducted in accordance with the PRISMA guidelines. Only articles reporting individual data on stroke mechanism and etiology, sex, age, past cardiovascular risk factors, COVID symptoms, admission NIHSS, D-dimer levels, and acute stroke treatment were selected for the review. Articles that did not report the clinical description of the cases were excluded. A descriptive statistical analysis of the data collected was performed. Finding: From a total of 1,210 articles published from January 1, 2020, to July 23, 2020, 80 articles (275 patients), which satisfied the abovementioned criteria, were included in this review. A total of 226 cases of ischemic stroke (IS), 35 cases of intracranial bleeding, and 14 cases of CVST were found. Among patients with IS, the mean age was 64.16 ±14.73 years (range 27-92 years) and 53.5% were male. The mean NIHSS score reported at the onset of stroke was 15.23 ±9.72 (range 0-40). Primary endovascular thrombectomy (EVT) was performed in 24/168 patients (14.29%), intravenous thrombolysis (IVT) was performed in 17/168 patients (10.12%), and combined IVT+EVT was performed in 11/168 patients (6.55%). According to the reported presence of large vessel occlusion (LVO) (105 patients), 31 patients (29.52%) underwent primary EVT or bridging. Acute intracranial bleeding was reported in 35 patients: 24 patients (68.57%) had intracerebral hemorrhage (ICH), 4 patients (11.43%) Fraiman et al. COVID-19 and Cerebrovascular Diseases had non-traumatic subarachnoid hemorrhage (SAH), and the remaining 7 patients (20%) had the simultaneous presence of SAH and ICH. Fourteen cases of CVST were reported in the literature (50% males), mean age 42.8 years ±15.47 (range 23-72). Treatment was reported only in nine patients; seven were treated with anticoagulant therapy; one with acetazolamide, and one underwent venous mechanical thrombectomy. Conclusion: Cerebrovascular events are relatively common findings in COVID-19 infection, and they could have a multifactorial etiology. More accurate and prospective data are needed to better understand the impact of cerebrovascular events in COVID-19 infection.

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Section: Discussionmentioning

confidence: 99%

Section: Cerebral Venous Sinus Thrombosismentioning

confidence: 99%

COVID-19 and Cerebrovascular Diseases: A Systematic Review and Perspectives for Stroke Management

et al. 2020

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“…A cumulative data was defined as an amalgam of the current series and the previously reported cases [6][7][8][9][10][11][12][13][14][15][16][17][18]. A comparison between this cumulative data and some large-volume CVST studies performed before the COVID-19 pandemic [1,3,4,21,22], has been made ( Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…This study represents a case series of CVST associated with SARS-CoV-2 infection, diagnosed and treated at multiple institutions throughout Iran. We provided a brief overview of all previously reported cases in Table 2 as well [6][7][8][9][10][11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…Since the evolution of the Coronavirus Disease 2019 (COVID-19) pandemic, non-respiratory manifestations of the disease like neurological manifestations [5] and thrombotic events have been progressively appreciated. Although there are some case reports and one case series [6][7][8][9][10][11][12][13][14][15][16][17][18] showing the association of the CVST and SARS-CoV-2 infection, the data about diagnosis and prognosis in this association is still limited. We investigated the demographic, clinical, radiological, and prognostic characteristics of this association to improve the diagnosis and treatment of patients with CVST and COVID-19.…”

Section: Introductionmentioning

confidence: 99%

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Cerebral Venous Sinus Thrombosis Associated with COVID-19: A Case Series and Literature Review

Ostovan

Foroughi

Rostami

et al. 2020

Preprint

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Background: Since the COVID-19 pandemic, several cases of cerebral venous sinus thrombosis (CVST) have been reported in SARS-CoV-2 infected individuals. This study provides a series of patients with CVST and SARS-CoV-2 infection.Methods: Consecutive patients with documented SARS-CoV-2 infection, as well as clinical and radiological characteristics of CVST, were reported from three teaching hospitals in the South West, North West, and the center of Iran from June to July 2020. We also searched the abstract archives until the end of August 2020 and gathered 28 reported cases. The diagnostic criteria for SARS-CoV-2 infection were determined according to SARS-CoV-2 detection in oropharyngeal or nasopharyngeal samples in clinically suspected patients. Demographics, main COVID-19 symptoms, confirmatory tests for SARS-CoV-2 infection diagnosis, the interval between the diagnosis of SARS-CoV-2 infection and CVST, clinical and radiological features of CVST, therapeutic strategies, CVST outcomes, rate of hemorrhagic transformation, and mortality rate were investigated.Results: Six patients (aged 31 to 62 years old) with confirmed CVST and SARS-CoV-2 infection were admitted to our centers. Four patients had no respiratory symptoms of SARS-CoV-2 infection. Five out of six patients developed the clinical manifestations of CVST and SARS-CoV-2 infection simultaneously. Three patients had known predisposing factors for CVST. Despite receiving CVST and SARS-CoV-2 infection treatments, four out of six patients passed away.Conclusions: The role of SARS-CoV-2 as a “cause” versus an “additive contributor” remains to be elucidated. Practitioners should be aware of the possibility of CVST in SARS-CoV-2 infection.

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Coronavirus disease 19 (COVID‐19) and Cerebral venous sinus thrombosis (CVST): A case series and review of the literature

Kallel

Saidani

Kotti

et al. 2022

Clinical Case Reports

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A large proportion of patients with coronavirus disease 19 (COVID‐19) suffer from excessive coagulation activation and coagulopathy which predisposes them to a wide spectrum of thrombotic events including in situ pulmonary thrombosis, deep‐vein thrombosis, and associated pulmonary embolism, as well as arterial thrombotic events. Cerebral venous sinus thrombosis (CVST) have also been reported but in a very small number of cases. This report aims to increase awareness about CVST as a potential neurological thromboembolic complication in patients with coronavirus disease. We report three COVID ‐ 19 patients presenting with CVTS. We also review all previously described cases and present an overview of their demographic, clinical, and diagnostic data. We describe three patients with concomitant coronavirus disease and CVST among 1000 hospitalized COVID‐19 patients (2 males, 1female, and mean age of 37 years). One patient was previously healthy, while the two others had a history of chronic anemia and ulcerative colitis, respectively. CVST symptoms including seizure in two patients and headache in one patient occurred day to weeks after the onset of COVID‐19 symptoms. Three months of anticoagulant therapy was given for all three patients with favorable outcomes. No neurological sequelae and no recurrence occurred within 6 months after hospital discharge. Our search identified 33 cases of COVID‐19 complicated by CVST. The mean age was 45.3 years, there was a slight male predominance (60%), and more than half of cases were diagnosed in previously healthy individuals. All cases of CVT were clinically symptomatic and were observed in patients with a different spectrum of coronavirus disease severity. Headache was the most common complaint, reported by just less than half of patients. There was a high mortality rate (30.3%). CVT is a very rare, but potentially life‐threatening complication in patients with COVID‐19. It's mainly reported in relatively young individuals with no or little comorbid disease and can occur even in patients who do not display severe respiratory symptoms. Atypical clinical presentations may pose a challenge to the early diagnosis and treatment. High suspicion is necessary as early diagnosis and prompt treatment with anticoagulation in all patients with COVID‐19 and CVT could contain the mortality rate and improve neurological outcomes in these patients.

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COVID-19 as triggering co-factor for cortical cerebral venous thrombosis?

Abstract: COVID-19 as triggering co-factor for cortical cerebral venous thrombosis?

Cited by 22 publications

References 12 publications

COVID-19 and Cerebrovascular Diseases: A Systematic Review and Perspectives for Stroke Management

COVID-19 and Cerebrovascular Diseases: A Systematic Review and Perspectives for Stroke Management

Cerebral Venous Sinus Thrombosis Associated with COVID-19: A Case Series and Literature Review

Coronavirus disease 19 (COVID‐19) and Cerebral venous sinus thrombosis (CVST): A case series and review of the literature

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