van de Munckhof, Anita; Krzywicka, Katarzyna; Aguiar de Sousa, Diana; Sánchez van Kammen, Mayte; Heldner, Mirjam R.; Jood, Katarina; Lindgren, Erik; Tatlisumak, Turgut; Putaala, Jukka; Kremer Hovinga, Johanna A.; Middeldorp, Saskia; Levi, Marcel; Arnold, Marcel; Ferro, José M; Coutinho, Jonathan M (2022). Declining mortality of cerebral venous sinus thrombosis with thrombocytopenia after SARS-CoV-2 vaccination. European journal of neurology, 29(1), pp. 339-344. Wiley 10.1111/ene.15113
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BACKGROUND
High mortality rates have been reported in patients with cerebral venous sinus thrombosis (CVST) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) after vaccination with adenoviral vector SARS-CoV-2 vaccines. The aim of this study was to evaluate whether mortality of patients with CVST-VITT has decreased over time.
METHODS
We used the EudraVigilance database of the European Medicines Agency to identify cases of CVST with concomitant thrombocytopenia occurring within 28 days of SARS-CoV-2 vaccination. Vaccines were grouped based on vaccine type (adenoviral or mRNA). Cases with CVST onset until 28 March were compared to cases after 28 March 2021, which was the day when the first scientific paper on VITT was published.
RESULTS
We identified 270 cases of CVST with thrombocytopenia, of which 266 (99%) occurred after adenoviral vector SARS-CoV-2 vaccination (ChAdOx1 nCoV-19 n=243, Ad26.COV2.S n=23). Reported mortality among adenoviral cases with onset up to 28 March 2021 was 47/99 (47%, 95%CI 37-58%) compared to 36/167 (22%, 95%CI 16-29%) in cases with onset after 28 March (p=<0.001). None of the 4 cases of CVST with thrombocytopenia occurring after mRNA vaccination died.
CONCLUSION
Reported mortality of CVST with thrombocytopenia after vaccination with adenoviral vector-based SARS-CoV-2 vaccines has significantly decreased over time, which may indicate a beneficial effect of earlier recognition and/or improved treatment on outcome after VITT.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology 04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Haematology and Central Haematological Laboratory |
UniBE Contributor: |
Heldner, Mirjam Rachel, Kremer Hovinga Strebel, Johanna Anna, Arnold, Marcel |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
1468-1331 |
Publisher: |
Wiley |
Language: |
English |
Submitter: |
Pierrette Durand Lüthi |
Date Deposited: |
07 Oct 2021 08:54 |
Last Modified: |
17 Apr 2023 13:10 |
Publisher DOI: |
10.1111/ene.15113 |
PubMed ID: |
34536256 |
Uncontrolled Keywords: |
COVID-19 Vaccines Cerebral Venous Sinus Thrombosis Intracranial Mortality Sinus Thrombosis Thrombocytopenia |
BORIS DOI: |
10.48350/159488 |
URI: |
https://boris.unibe.ch/id/eprint/159488 |
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