Characteristics and outcomes of cerebral venous thrombosis associated with COVID-19.

Scutelnic, Adrian; van de Munckhof, Anita; Miraclin, Angel T; Aaron, Sanjith; Hameed, Sajid; Wasay, Mohammad; Grosu, Oxana; Krzywicka, Katarzyna; Sánchez van Kammen, Mayte; Lindgren, Erik; Moreira, Tiago; Acampora, Roberto; Negro, Alberto; Karapanayiotides, Theodoros; Yaghi, Shadi; Revert, Anna; Cuadrado Godia, Elisa; Garcia-Madrona, Sebastian; La Spina, Paolino; Grillo, Francesco; ... (2024). Characteristics and outcomes of cerebral venous thrombosis associated with COVID-19. European stroke journal, 9(3), pp. 676-686. Sage 10.1177/23969873241241885

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INTRODUCTION

Previous reports and meta-analyses derived from small case series reported a mortality rate of up to 40% in patients with coronavirus disease 2019 associated cerebral venous thrombosis (COVID-CVT). We assessed the clinical characteristics and outcomes in an international cohort of patients with COVID-CVT.

PATIENTS AND METHODS

This was a registry study of consecutive COVID-CVT patients diagnosed between March 2020 and March 2023. Data collected by the International Cerebral Venous Thrombosis Consortium from patients with CVT diagnosed between 2017 and 2018 served as a comparison. Outcome analyses were adjusted for age and sex.

RESULTS

We included 70 patients with COVID-CVT from 23 hospitals in 15 countries and 206 controls from 14 hospitals in 13 countries. The proportion of women was smaller in the COVID-CVT group (50% vs 68%, p < 0.01). A higher proportion of COVID-CVT patients presented with altered mental state (44% vs 25%, p < 0.01), the median thrombus load was higher in COVID-CVT patients (3 [IQR 2-4] vs 2 [1-3], p < 0.01) and the length of hospital stay was longer compared to controls (11 days [IQR 7-20] vs 8 [4-15], p = 0.02). In-hospital mortality did not differ (5/67 [7%, 95% CI 3-16] vs 7/206 [3%, 2-7], aOR 2.6 [95% CI 0.7-9]), nor did the frequency of functional independence after 6 months (modified Rankin Scale 0-2; 45/58 [78%, 95% CI 65-86] vs 161/185 [87%, 81-91], aOR 0.5 [95% CI 0.2-1.02]).

CONCLUSION

In contrast to previous studies, the in-hospital mortality rate and functional outcomes during follow-up did not differ between COVID-CVT patients and the pre-COVID-19 controls.

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