Pathogeny of cerebral venous thrombosis in SARS-Cov-2 infection

Guendouz, Cécile; Quenardelle, Véronique; Riou‐Comte, Nolwenn; Welfringer, P.; Wolff, Valérie; Zuily, Stéphane; Jager, Lavinia; Selton, Lisa Humbertjean; Mione, Gioia; Pop, Raoul; Gory, Benjamin; Richard, Sébastien

doi:10.1097/md.0000000000024708

Cited by 14 publications

(12 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Posterior reversible encephalopathy syndrome (PRES) has also been described in patients with headaches and other neurological symptoms during severe COVID‐19 (Lallana et al., 2021). Although not a common finding, central venous thrombosis (CVT) has been described in patients with COVID‐19 (Guendouz et al., 2021). While the specific underlying mechanisms related to headache in SARS‐CoV‐2 infection are not yet clear, it is possible that the endothelial dysfunction and coagulopathy induced by SARS‐CoV‐2 infection may contribute to alterations in venous outflow or CSF absorption leading to intracranial hypertension in some patients.…”

Section: The Clinical Spectrum Of Neurologic Manifestations In Covid‐19mentioning

confidence: 99%

Neurochemical biomarkers to study CNS effects of COVID‐19: A narrative review and synthesis

Edén

Simrén

Price

et al. 2021

Journal of Neurochemistry

View full text Add to dashboard Cite

Neurological symptoms are frequently reported in patients suffering from COVID‐19. Common CNS‐related symptoms include anosmia, caused by viral interaction with either neurons or supporting cells in nasal olfactory tissues. Diffuse encephalopathy is the most common sign of CNS dysfunction, which likely results from the CNS consequences of the systemic inflammatory syndrome associated with severe COVID‐19. Additionally, microvascular injuries and thromboembolic events likely contribute to the neurologic impact of acute COVID‐19. These observations are supported by evidence of CNS immune activation in cerebrospinal fluid (CSF) and in autopsy tissue, along with the detection of microvascular injuries in both pathological and neuroimaging studies. The frequent occurrence of thromboembolic events in patients with COVID‐19 has generated different hypotheses, among which viral interaction with perivascular cells is particularly attractive, yet unproven. A distinguishing feature of CSF findings in SARS‐CoV‐2 infection is that clinical signs characteristic of neurotropic viral infections (CSF pleocytosis and blood–brain barrier injury) are mild or absent. Moreover, virus detection in CSF is rare and often of uncertain significance. In this review, we provide an overview of the neurological impact that occurs in the acute phase of COVID‐19, and the role of CSF biomarkers in the clinical management and research to better treat and understand the disease. In addition to aiding as diagnostic and prognostic tools during acute infection, the use of comprehensive and well‐characterized CSF and blood biomarkers will be vital in understanding the potential impact on the CNS in the rapidly increasing number of individuals recovering from COVID‐19.

show abstract

Section: The Clinical Spectrum Of Neurologic Manifestations In Covid‐19mentioning

confidence: 99%

Neurochemical biomarkers to study CNS effects of COVID‐19: A narrative review and synthesis

Edén

Simrén

Price

et al. 2021

Journal of Neurochemistry

View full text Add to dashboard Cite

show abstract

“…27,47 Two other studies demonstrated safety with the use of dabigatran but, due to the sample size, there was no consensus about the superiority of this drug in patients infected with SARS-CoV-2. 48,49 Studies have shown a significant reduction in mortality in patients treated with anticoagulation, irrespective of the choice between UFH and HBPM, mainly in individuals with very high levels of D-dimer. 48 Preventive anticoagulation continues to be recommended for patients with severe infection.…”

Section: Treatment Anticoagulantsmentioning

confidence: 99%

“…48,49 Studies have shown a significant reduction in mortality in patients treated with anticoagulation, irrespective of the choice between UFH and HBPM, mainly in individuals with very high levels of D-dimer. 48 Preventive anticoagulation continues to be recommended for patients with severe infection. 48 The use of other medication, such as recombinant tissue plasminogen activator (rt-PA) was associated with a temporary clinical improvement, but did not interfere with the mortality of patients with COVID-19-related CVT.…”

Section: Treatment Anticoagulantsmentioning

confidence: 99%

“…48 Preventive anticoagulation continues to be recommended for patients with severe infection. 48 The use of other medication, such as recombinant tissue plasminogen activator (rt-PA) was associated with a temporary clinical improvement, but did not interfere with the mortality of patients with COVID-19-related CVT. 12…”

Section: Treatment Anticoagulantsmentioning

confidence: 99%

“…55 In addition, there seems to be no direct connection between the severity of respiratory symptoms and CVT-related mortality. 13,38,48,56,58 There is a consensus over the prescription of anticoagulants and their effect on the rates of patient mortality and recovery. 7,21,23,46,53 Moreover, the difference in the patient's evolution appears to be subtle when compared to surgery and the use of anticoagulants, such that the outcome of death and worse prognoses are linked to high systemic inflammation indices.…”

Section: Outcomementioning

confidence: 99%

See 2 more Smart Citations

Cerebral venous thrombosis and Covid 19: Literature review

Zicarelli¹,

Martins²,

Doni³

et al. 2021

JNSK

View full text Add to dashboard Cite

Introduction: Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) was first detected in December 2019 in the city of Wuhan, China, and has since taken on worldwide proportions. It is known that individuals with Coronavirus disease-19 (COVID-19) have systemic clinical manifestations. Among the multisystemic effects, cerebral venous thrombosis (CVT) is responsible for high mortality rates. In this sense, understanding the association between CVT and SARS-CoV-2 infection directly impacts the disease's morbidity and mortality. Methodology: Literature review in the PubMed and Embase databases, with the following search terms: “COVID-19”, “SARS-CoV-2”, “Venous thromboembolism”, “Thrombosis”, “Cerebral Venous Thrombosis”, “Intracranial Sinus Thrombosis” and “Cranial Sinus Thrombosis”. The selected articles were written in English, which addressed the various aspects of COVID-19. Results and discussion: CVT are a rare complication of COVID-19, with an incidence between 0.02 to 1% of hospitalized patients. However, it can reach about 75% of mortality in affected individuals. Pathophysiology seems to be associated with the state of hypercoagulability and the systemic inflammatory process resulting from viral infection. Thus, recent studies show a consensus on the early anticoagulation of patients affected by the virus, to reduce mortality in these cases. However, the differences between the types of anticoagulation, Low Molecular Weight Heparin (LMWH), Unfractionated Heparin (UFH), Dabigatran have not yet been well established, although there is a predilection for the use of LMWH. Also, thrombectomy is a therapeutic intervention option that should be evaluated, due to the risk of additional endothelial injury from the use of stent retrievers. Conclusion: Although it has a relatively low incidence, CVT aggravates the condition and increases the risk of death for patients with COVID-19. Because of this, early diagnosis and evaluation of therapeutic options for CVT are essential for the development of clinical management.

show abstract

Cerebrovascular Manifestations of SARS-CoV-2: A Comprehensive Review

Stefanou¹,

Karvelas

Bennett

et al. 2023

Curr Treat Options Neurol

View full text Add to dashboard Cite

Purpose of review The risks of cerebrovascular manifestations due to SARS-CoV-2 infection are significantly increased within the first 6 months of the infection. Our work aims to give an update on current clinical aspects of diagnosis and treatment of cerebrovascular manifestations during acute and long-term SARS-CoV-2 infection. Recent findings The incidence of acute ischemic stroke and haemorrhagic stroke during acute SARS-CoV-2 patients is estimated at 0.9 to 4.6% and 0.5–0.9%, respectively, and were associated with increased mortality. The majority presented with hemiparesis, dysarthria, sensory deficits, and a NIHSS score within 5–15. In addition, beyond the first 30 days of infection people with COVID-19 exhibited increased risk of stroke. During acute phase, age, hypertension, diabetes, and medical history of vascular disease were increased in patients with COVID-19 with new onset of cerebrovascular manifestations, while during long-COVID-19, the risk of cerebrovascular manifestations were found increased regardless of these factors. The management of patients with large-vessel ischemic stroke fulfilling the intravenous thrombolysis criteria are successfully treated according to the guidelines, while hyperosmolar therapy is typically administered in 4- to 6-h intervals. In addition, prophylaxis of anticoagulation therapy is associated with a better prognosis and low mortality during acute and post hospital discharge of patients with COVID-19. Summary In this work, we provide a comprehensive review of the current literature on acute and post-acute COVID-19 cerebrovascular sequelae, symptomatology, and its pathophysiology mechanisms. Moreover, we discuss therapeutic strategies for these patients during acute and long-term care and point populations at risk. Our findings suggest that older patients with risk factors such as hypertension, diabetes, and medical history of vascular disease are more likely to develop cerebrovascular complications.

show abstract

Pathogeny of cerebral venous thrombosis in SARS-Cov-2 infection

Cited by 14 publications

References 46 publications

Neurochemical biomarkers to study CNS effects of COVID‐19: A narrative review and synthesis

Neurochemical biomarkers to study CNS effects of COVID‐19: A narrative review and synthesis

Cerebral venous thrombosis and Covid 19: Literature review

Cerebrovascular Manifestations of SARS-CoV-2: A Comprehensive Review

Contact Info

Product

Resources

About