tetano
Editor, Senior Moderator
J Stroke
. 2022 May;24(2):256-265.
doi: 10.5853/jos.2022.00752. Epub 2022 May 31.
Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality
Thanh N Nguyen[SUP] 1 2 [/SUP], Muhammad M Qureshi[SUP] 2 3 [/SUP], Piers Klein[SUP] 1 2 [/SUP], Hiroshi Yamagami[SUP] 4 [/SUP], Mohamad Abdalkader[SUP] 2 [/SUP], Robert Mikulik[SUP] 5 [/SUP], Anvitha Sathya[SUP] 1 2 [/SUP], Ossama Yassin Mansour[SUP] 6 [/SUP], Anna Czlonkowska[SUP] 7 [/SUP], Hannah Lo[SUP] 1 2 [/SUP], Thalia S Field[SUP] 8 [/SUP], Andreas Charidimou[SUP] 1 [/SUP], Soma Banerjee[SUP] 9 [/SUP], Shadi Yaghi[SUP] 10 [/SUP], James E Siegler[SUP] 11 [/SUP], Petra Sedova[SUP] 5 [/SUP], Joseph Kwan[SUP] 9 [/SUP], Diana Aguiar de Sousa[SUP] 12 [/SUP], Jelle Demeestere[SUP] 13 [/SUP], Violiza Inoa[SUP] 14 [/SUP], Setareh Salehi Omran[SUP] 15 [/SUP], Liqun Zhang[SUP] 16 [/SUP], Patrik Michel[SUP] 17 [/SUP], Davide Strambo[SUP] 17 [/SUP], João Pedro Marto[SUP] 18 [/SUP], Raul G Nogueira[SUP] 19 [/SUP], SVIN COVID-19 Global COVID Stroke Registry
Affiliations
Abstract
Background and purpose: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year.
Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020).
Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths.
Conclusions: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.
Keywords: COVID-19; Cerebral venous thrombosis; Mortality; SARS-CoV-2; Stroke; Vaccine-induced immune thrombotic thrombocytopenia.
. 2022 May;24(2):256-265.
doi: 10.5853/jos.2022.00752. Epub 2022 May 31.
Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality
Thanh N Nguyen[SUP] 1 2 [/SUP], Muhammad M Qureshi[SUP] 2 3 [/SUP], Piers Klein[SUP] 1 2 [/SUP], Hiroshi Yamagami[SUP] 4 [/SUP], Mohamad Abdalkader[SUP] 2 [/SUP], Robert Mikulik[SUP] 5 [/SUP], Anvitha Sathya[SUP] 1 2 [/SUP], Ossama Yassin Mansour[SUP] 6 [/SUP], Anna Czlonkowska[SUP] 7 [/SUP], Hannah Lo[SUP] 1 2 [/SUP], Thalia S Field[SUP] 8 [/SUP], Andreas Charidimou[SUP] 1 [/SUP], Soma Banerjee[SUP] 9 [/SUP], Shadi Yaghi[SUP] 10 [/SUP], James E Siegler[SUP] 11 [/SUP], Petra Sedova[SUP] 5 [/SUP], Joseph Kwan[SUP] 9 [/SUP], Diana Aguiar de Sousa[SUP] 12 [/SUP], Jelle Demeestere[SUP] 13 [/SUP], Violiza Inoa[SUP] 14 [/SUP], Setareh Salehi Omran[SUP] 15 [/SUP], Liqun Zhang[SUP] 16 [/SUP], Patrik Michel[SUP] 17 [/SUP], Davide Strambo[SUP] 17 [/SUP], João Pedro Marto[SUP] 18 [/SUP], Raul G Nogueira[SUP] 19 [/SUP], SVIN COVID-19 Global COVID Stroke Registry
Affiliations
- PMID: 35677980
- DOI: 10.5853/jos.2022.00752
Abstract
Background and purpose: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year.
Methods: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020).
Results: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths.
Conclusions: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.
Keywords: COVID-19; Cerebral venous thrombosis; Mortality; SARS-CoV-2; Stroke; Vaccine-induced immune thrombotic thrombocytopenia.