Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality

Nguyen T.N.; Qureshi M.M.; Klein P.; Yamagami H.; Abdalkader M.; Mikulik R.; Sathya A.; Mansour O.Y.; Czlonkowska A.; Lo H.; Field T.S.; Charidimou A.; Banerjee S.; Yaghi S.; Siegler J.E.; Sedova P.; Kwan J.; de Sousa D.A.; Demeestere J.; Inoa V.; Omran S.S.; Zhang L.; Michel P.; Strambo D.; Marto J.P.; Nogueira R.G.; Lereis V.P.; Ma A.; Enzinger C.; Gattringer T.; Rahman A.; Bonnet T.; De Raedt S.; Lemmens R.; Ligot N.; Vandervorst F.; Conforto A.B.; Hidalgo R.C.T.; Cuervo D.L.M.; Neves L.O.; da Silva I.L.; Martins R.T.; Rebello L.C.; Santiago I.B.; Alexiev F.; Sakelarova T.; Kalpachki R.; Cora E.A.; Kelly M.E.; Pikula A.; Chen H.-S.; Chen Y.; Yang S.; Bedekovic M.R.; Čabal M.; Tenora D.; Dušek P.; Fibrich P.; Hrabanovska E.; Hlaváčová H.; Jurák L.; Kadlckova J.; Karpowicz I.; Klečka L.; Kovář M.; Neumann J.; Paloušková H.; Reiser M.; Rohan V.; Skoda O.; Škorňa M.; Šimůnek L.; Šrámek M.; Drenck N.; Sobh K.; Strbian D.; Lesaine E.; Reiner P.; Rouanet F.; Sabben C.; Boskamp S.; Mbroh J.; Nagel S.; Poli S.; Rosenkranz M.; Thomalla G.; Karapanayiotides T.; Kargiotis O.; Koutroulou I.; Palaiodimou L.; Tsivgoulis G.; Guerra J.D.B.; Huded V.; Nagendra S.; Prajapati C.; Sylaja P.N.; Sani A.F.; Ghoreishi A.; Hashemilar M.; Sadeghi-Hokmabadi E.; Rahal F.; Sabetay S.I.; Acampa M.; Adami A.; Longoni M.; Ornello R.; Renieri L.; Romoli M.; Sacco S.; Salmaggi A.; Sangalli D.; Zini A.; Fujita K.; Fukuda H.; Matsumaru Y.; Miyake K.; Ohara N.; Sakaguchi M.; Sakai K.; Shindo S.; Sonoda K.; Sugiura Y.; Takenobu Y.; Toyoda K.; Uwatoko T.; Yamamoto R.; Yazawa Y.; Yoshimoto T.; Baek J.-H.; Lee J.S.; Lee S.B.; Seo K.-D.; Sohn S.-I.; Arsovska A.A.; Chieh C.Y.; Zaidi W.A.W.; Yahya W.N.N.W.; Gongora-Rivera F.; Martinez-Marino M.; Infante-Valenzuela A.; Dippel D.; van Dam-Nolen D.H.K.; Punter M.; Wu T.Y.; Sunmonu T.A.; Adebayo T.T.; Wahab K.W.; Bello A.H.; Sundseth A.; Kristoffersen E.S.; Al Hashmi A.M.; Ahmad S.; Rashid U.; Rodriguez-Kadota L.; Vences M.Á.; Yalung P.M.; Brola W.; Dębiec A.; Dorobek M.; Karlinski M.A.; Labuz-Roszak B.M.; Lasek-Bal A.; Sienkiewicz-Jarosz H.; Staszewski J.; Sobolewski P.; Wiącek M.; Zielinska-Turek J.; Araújo A.P.; Ferreira P.; Fonseca L.; Nunes A.P.; Silva M.L.; Castro P.; Rocha M.; Rodrigues M.; Pinho E Melo T.; Ciopleias B.; Dimitriade A.; Falup-Pecurariu C.; Venketasubramanian N.; Krastev G.; Haring J.; Ayo-Martin O.; Blasco J.; Cruz-Culebras A.; Hernandez-Fernandez F.; Moniche F.; Guillan M.; Sánchez M.J.G.; Montaner J.; Perez-Sanchez S.; Rodríguez-Vázquez A.; Bolognese M.; Bernava G.; Carrera E.; Churojana A.; Aykac O.; Bajrami A.; Ozdemir A.O.; Senadim S.; Hussain S.I.; John S.; Krishnan K.; Lenthall R.; Asif K.S.; Biller J.; Below K.; Chebl A.; Chen M.; Colasurdo M.; Czap A.; Dharmadhikari S.; de Havenon A.H.; Eskey C.J.; Farooqui M.; Feske S.K.; Goyal N.; Grimmett K.B.; Guzik A.K.; Haussen D.C.; Hovingh M.; Jillela D.; Kan P.T.; Khatri R.; Khoury N.N.; Kiley N.L.; Kolikonda M.K.; Lara S.; Li G.; Linfante I.; Loochtan A.I.; Lopez C.D.; Lycan S.; Male S.S.; Maali L.; Masoud H.E.; Min J.; Mohamed G.A.; Mohammaden M.; Nahab F.; Nalleballe K.; Ortega-Gutierrez S.; Radaideh Y.; Ramakrishnan P.; Rayo-Taranto B.; Rojas-Soto D.M.; Ruland S.; Sheth S.A.; Simpkins A.N.; Starosciak A.K.; Tarlov N.E.; Taylor R.A.; Voetsch B.; Zhang L.; Duong H.Q.; Vu Le H.; Pham T.N.; Tran A.D.; Ton M.D.; Dao V.-P.; Zaidat O.O.; Machi P.; Dirren E.; Fernández C.R.; López J.E.; Ferro J.C.F.; Mohammadzadeh N.; Suryadevara N.C.; Jancar N. · Journal of Stroke (2022) · DOI: 10.5853/jos.2022.00752

Resumen

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.