SARS-CoV-2 infection showing signs of cerebral sinus vein thrombosis in the infantile period

Arga, Gül; Erkol, Hatice Gül; Taşkın, Esra Çakmak; Konca, Hatice Kübra; Taş, İlayda; Erdoğan, Burcu Özge; Özdemir, Halil; Çakmaklı, Hasan Fatih; Kahveci, Fevzi; Demir, Burak Furkan; Kendirli, Tanıl; Fítöz, Suat; Çıftçı, Ergın

doi:10.1016/j.dscb.2022.100051

Cited by 2 publications

(8 citation statements)

References 17 publications

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“…We retrospectively reviewed the clinical history of 60 MIS-C patients who experienced TEs (37 studies) and we collected epidemiological, clinical, laboratory, and treatment data ( Table 1 ) [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ].…”

Section: Resultsmentioning

confidence: 99%

Thrombotic Events in MIS-C Patients: A Single Case Report and Literature Review

et al. 2023

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Multisystem Inflammatory Syndrome in Children (MIS-C) is a systemic hyperinflammatory disorder that is associated with a hypercoagulable state and a higher risk of thrombotic events (TEs). We report the case of a 9-year-old MIS-C patient with a severe course who developed a massive pulmonary embolism that was successfully treated with heparin. A literature review of previous TEs in MIS-C patients was conducted (60 MIS-C cases from 37 studies). At least one risk factor for thrombosis was observed in 91.7% of patients. The most frequently observed risk factors were pediatric intensive care unit hospitalization (61.7%), central venous catheter (36.7%), age >12 years (36.7%), left ventricular ejection fraction <35% (28.3%), D-dimer >5 times the upper limit of normal values (71.9%), mechanical ventilation (23.3%), obesity (23.3%), and extracorporeal membrane oxygenation (15%). TEs may concurrently affect multiple vessels, including both arterial and venous. Arterial thrombosis was more frequent, mainly affecting the cerebral and pulmonary vascular systems. Despite antithrombotic prophylaxis, 40% of MIS-C patients developed TEs. Over one-third of patients presented persistent focal neurological signs, and ten patients died, half of whom died because of TEs. TEs are severe and life-threatening complications of MIS-C. In case with thrombosis risk factors, appropriate thromboprophylaxis should be promptly administered. Despite proper prophylactic therapy, TEs may occur, leading in some cases to permanent disability or death.

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Section: Resultsmentioning

confidence: 99%

Thrombotic Events in MIS-C Patients: A Single Case Report and Literature Review

et al. 2023

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“…We read with interest the article by Arga et al about a 40 day old male who was diagnosed with septic shock and cerebral venous sinus thrombosis (CVST) without identifying an infectious agent other than SARS-CoV-2 by PCR on a naso-pharyngeal swab test but not in the cerebrospinal fluid (CSF) [1] . Upon empirical antibiotic treatment and low-molecular weight heparin (LMWH) the patient recovered neurologically completely [1] . The study is appealing but carries limitations that raise concerns and should be discussed.…”

Section: Letter To the Editormentioning

confidence: 99%

“…Another limitation is that the cause of sepsis could not be clarified [1] . Readers should know if there was eosinophilia, if IgE levels were elevated, or if blood or CSF cultures for fungi were carried out.…”

Section: Letter To the Editormentioning

confidence: 99%

“…A further limitation of the study is that no results of multimodal cerebral MRI were provided [1] . CVST is often complicated by seizures, ischemic stroke or bleeding.…”

Section: Letter To the Editormentioning

confidence: 99%

“…Because the patient was lethargic, restless, and sleepy, results of multimodal cerebral MRI with contrast medium are mandatory to rule out encephalitis, ventriculitis, and stroke. Encephalitis may be present even in the absence of pleocytosis [4] and the only abnormal CSF finding may be elevated CSF protein, as in the index patient [1] .…”

Section: Letter To the Editormentioning

confidence: 99%

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Before blaming SARS-CoV-2 for venous sinus thrombosis in a septic patient, consider alternative etiologies

Finsterer¹

2023

Brain Disorders

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SARS-CoV-2 infection showing signs of cerebral sinus vein thrombosis in the infantile period

Cited by 2 publications

References 17 publications

Thrombotic Events in MIS-C Patients: A Single Case Report and Literature Review

Thrombotic Events in MIS-C Patients: A Single Case Report and Literature Review

Before blaming SARS-CoV-2 for venous sinus thrombosis in a septic patient, consider alternative etiologies

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