AJNR Am J Neuroradiol . Cerebral Venous Thrombosis in COVID-19: A New York Metropolitan Cohort Study

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AJNR Am J Neuroradiol


. 2021 Apr 22.
doi: 10.3174/ajnr.A7134. Online ahead of print.
Cerebral Venous Thrombosis in COVID-19: A New York Metropolitan Cohort Study


F Al-Mufti ^{1 2} , K Amuluru ³ , R Sahni ^{4 2} , K Bekelis ⁵ , R Karimi ⁶ , J Ogulnick ² , J Cooper ⁴ , P Overby ⁴ , R Nuoman ⁴ , A Tiwari ⁷ , K Berekashvili ⁷ , N Dangayach ⁸ , J Liang ⁸ , G Gupta ⁹ , P Khandelwal ⁹ , J F Dominguez ⁴ , T Sursal ⁴ , H Kamal ² , K Dakay ² , B Taylor ⁹ , E Gulko ^{4 2} , M El-Ghanem ¹⁰ , S A Mayer ^{4 2} , C Gandhi ^{4 2}



Affiliations

• PMID: 33888450
• DOI: 10.3174/ajnr.A7134

Abstract

Background and purpose: Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is associated with hypercoagulability. We sought to evaluate the demographic and clinical characteristics of cerebral venous thrombosis among patients hospitalized for coronavirus disease 2019 (COVID-19) at 6 tertiary care centers in the New York City metropolitan area.
Materials and methods: We conducted a retrospective multicenter cohort study of 13,500 consecutive patients with COVID-19 who were hospitalized between March 1 and May 30, 2020.
Results: Of 13,500 patients with COVID-19, twelve had imaging-proved cerebral venous thrombosis with an incidence of 8.8 per 10,000 during 3 months, which is considerably higher than the reported incidence of cerebral venous thrombosis in the general population of 5 per million annually. There was a male preponderance (8 men, 4 women) and an average age of 49 years (95% CI, 36-62 years; range, 17-95 years). Only 1 patient (8%) had a history of thromboembolic disease. Neurologic symptoms secondary to cerebral venous thrombosis occurred within 24 hours of the onset of the respiratory and constitutional symptoms in 58% of cases, and 75% had venous infarction, hemorrhage, or both on brain imaging. Management consisted of anticoagulation, endovascular thrombectomy, and surgical hematoma evacuation. The mortality rate was 25%.
Conclusions: Early evidence suggests a higher-than-expected frequency of cerebral venous thrombosis among patients hospitalized for COVID-19. Cerebral venous thrombosis should be included in the differential diagnosis of neurologic syndromes associated with SARS-CoV-2 infection