Frequency of Thrombocytopenia and Platelet Factor 4/Heparin Antibodies in Patients With Cerebral Venous Sinus Thrombosis Prior to the COVID-19 Pandemic

Kammen, Mayte Sánchez van; Heldner, Mirjam R; Brodard, Justine; Scutelnic, Adrian; Silvis, Suzanne M.; Schroeder, Verena; Hovinga, Johanna A. Kremer; Levi, Marcel; Hiltunen, Sini; Lindgren, Erik; Mansour, Maryam; Araúz, Antonio; Barboza, Miguel A; Zuurbier, Susanna M.; Sousa, Diana Aguiar de; Ferro, José M.; Fischer, Urs; Field, Thalia S.; Jood, Katarina; Tatlısumak, Turgut; Putaala, Jukka; Arnold, Marcel; Coutinho, Jonathan M.

doi:10.1001/jama.2021.9889

Cited by 40 publications

(39 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…There is possible evidence that CSVT with thrombocytopenia may lead to earlier symptom onset [9]. In any case, the presence of platelet factor 4/heparin antibodies is clustered in patients with CSVT (after vaccination) compared with the pre-COVID-19 period, allowing conclusions about the pathophysiology of some but not all affected patients [10]. In our cases, none of our patients had thrombocytopenia or positive HIPA assay, and both benefited from anticoagulation with heparin.…”

Section: Discussionmentioning

confidence: 56%

Case report: cerebral sinus vein thrombosis in two patients with AstraZeneca SARS-CoV-2 vaccination

et al. 2021

View full text Add to dashboard Cite

SARS-CoV-2 infection is associated with an increased rate of thromboembolic events and mortality. Different vaccines are globally used to limit the pandemic. In this report, we present the case of two young female patients with newly diagnosed cerebral sinus vein thrombosis occurring after injection of the vector-based ChAdOx1 vaccine. Both patients presented with unusual headache only. The two of them used an estrogen-containing contraception, had had a history of deep venous thrombosis, and both had MTHFR mutations. Both patients developed SARS-CoV-2 specific humoral and cellular immunity including both CD4 and CD8 T cells. This rare, but serious complication needs to be considered after vaccination of young females, even if there is no evidence of heparin-induced thrombocytopenia.

show abstract

Section: Discussionmentioning

confidence: 56%

Case report: cerebral sinus vein thrombosis in two patients with AstraZeneca SARS-CoV-2 vaccination

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Cerebral hemorrhage occurs in some COVID-19 patients in the ICU ( 105 ). Some retrospective studies reported one patient with cerebral venous thrombosis and another with cerebral hemorrhage ( 106 ). Insomnia was also reported in some COVID-19 patients even after negative PCR results ( 107 ).…”

Section: Resultsmentioning

confidence: 99%

COVID-19: Pulmonary and Extra Pulmonary Manifestations

Elrobaa

New

2021

Front. Public Health

View full text Add to dashboard Cite

Introduction: The coronavirus disease-2019 (COVID-19) pandemic has been the most significant event in 2020, with ~86.8 million cases and 1.88 million deaths worldwide. It is a highly infectious disease, wherein the virus (severe acute respiratory syndrome coronavirus 2) rapidly multiplies and spreads to all parts of the body. Therefore, COVID-19 is not only respiratory disease but also a multisystem disease. Many people, including physicians, incorrectly believe that the disease affects only the respiratory tract. In this study, we aimed to describe COVID-19 manifestations and the underlying pathophysiology to provide the readers with a better understanding of this disease to achieve good management and to control the spread of this disease.Methods: Secondary data were obtained from PubMed, Google Scholar, and Scopus databases. The keywords used for the search were as follows: COVID-19, COVID-19 pulmonary manifestations, COVID-19 extra pulmonary manifestations, and pathophysiology of COVID-19. We collected secondary data from systemic reviews, metaanalyses, case series, and case reports in the form of public data that was published on websites of the government, medical corporations, medical peer-reviewed journals, and medical academies, all of which were indexed in PubMed, Google Scholar, or Scopus. Our questions were as follows: Is COVID-19 a respiratory disease only? and What are the extrapulmonary manifestations of COVID-19?Results: From our data, we found that a patient with COVID-19 may be either asymptomatic or symptomatic. Symptomatic cases may have either pulmonary or extrapulmonary manifestations. Pulmonary manifestations occur as mild, moderate, or severe cases. In mild and moderate cases, extrapulmonary manifestations such as gastroenteritis, fever, or vomiting may present alone. Some of these cases may be missed for diagnosis, and the patient may receive symptomatic treatment without a COVID-19 diagnosis, leading to increased spread of the infection. Extrapulmonary manifestations may occur in severe and critical cases as complications of severe infections (high viral overload) or the cytokine storm, such as in acute kidney injury (AKI), heart failure (HF), and venous thromboembolic (VTE) manifestation.Conclusion: COVID-19 is not a respiratory disease alone; rather, it is a multisystem disease. Pulmonary and extrapulmonary manifestations should be considered for early diagnosis and to control the spread of the infection.

show abstract

“…Thrombocytopenia was reported in 8.4% and HIT in 0.1% of the patients. No patient had anti-PF4-antibodies ( 7 ). The rarity of these findings underlines the distinct type of vaccine-associated CVST.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Take a Second Look: Covid-19 Vaccination-Related Cerebral Venous Thrombosis and Thrombotic Thrombocytopenia Syndrome

et al. 2021

View full text Add to dashboard Cite

We present two cases of ChAdOx1 nCov-19 (AstraZeneca)-associated thrombotic thrombocytopenia syndrome (TTS) and cerebral venous sinus thrombosis (CVST). At the time of emergency room presentation due to persistent headache, blood serum levels revealed reduced platelet counts. Yet, 1 or 4 days after the onset of the symptom, the first MR-angiography provided no evidence of CVST. Follow-up imaging, performed upon headache refractory to nonsteroidal pain medication verified CVST 2–10 days after initial negative MRI. Both the patients received combined treatment with intravenous immunoglobulins and parenteral anticoagulation leading to an increase of platelet concentration in both the individuals and resolution of the occluded cerebral sinus in one patient.

show abstract

Frequency of Thrombocytopenia and Platelet Factor 4/Heparin Antibodies in Patients With Cerebral Venous Sinus Thrombosis Prior to the COVID-19 Pandemic

Cited by 40 publications

References 24 publications

Case report: cerebral sinus vein thrombosis in two patients with AstraZeneca SARS-CoV-2 vaccination

Case report: cerebral sinus vein thrombosis in two patients with AstraZeneca SARS-CoV-2 vaccination

COVID-19: Pulmonary and Extra Pulmonary Manifestations

Case Report: Take a Second Look: Covid-19 Vaccination-Related Cerebral Venous Thrombosis and Thrombotic Thrombocytopenia Syndrome

Contact Info

Product

Resources

About