Cerebral Venous Sinus Thrombosis in COVID-19 Patients: A Multicenter Study and Review of Literature.
Adult
Aged
Aged, 80 and over
Biomarkers
/ analysis
COVID-19
/ complications
Cranial Sinuses
/ pathology
Cross-Sectional Studies
Female
Humans
Male
Middle Aged
Nervous System Diseases
/ etiology
Registries
Retrospective Studies
Risk Factors
Sinus Thrombosis, Intracranial
/ epidemiology
Tomography, X-Ray Computed
Treatment Outcome
COVID-19
CVST
Cerebral venous sinus thrombosis
SARS-CoV-2
Stroke
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
25
01
2021
revised:
23
02
2021
accepted:
28
02
2021
pubmed:
21
3
2021
medline:
14
5
2021
entrez:
20
3
2021
Statut:
ppublish
Résumé
COVID-19 infection has been known to predispose patients to both arterial and venous thromboembolic events such as deep venous thrombosis, pulmonary embolism, myocardial infarction, and stroke. A few reports from the literature suggest that Cerebral Venous Sinus Thrombosis (CVSTs) may be a direct complication of COVID-19. To review the clinical and radiological presentation of COVID-19 positive patients diagnosed with CVST. This was a multicenter, cross-sectional, retrospective study of patients diagnosed with CVST and COVID-19 reviewed from March 1, 2020 to November 8, 2020. We evaluated their clinical presentations, risk factors, clinical management, and outcome. We reviewed all published cases of CVST in patients with COVID-19 infection from January 1, 2020 to November 13, 2020. There were 8 patients diagnosed with CVST and COVID-19 during the study period at 7 out of 31 participating centers. Patients in our case series were mostly female (7/8, 87.5%). Most patients presented with non-specific symptoms such as headache (50%), fever (50%), and gastrointestinal symptoms (75%). Several patients presented with focal neurologic deficits (2/8, 25%) or decreased consciousness (2/8, 25%). D-dimer and inflammatory biomarkers were significantly elevated relative to reference ranges in patients with available laboratory data. The superior sagittal and transverse sinuses were the most common sites for acute CVST formation (6/8, 75%). Median time to onset of focal neurologic deficit from initial COVID-19 diagnosis was 3 days (interquartile range 0.75-3 days). Median time from onset of COVID-19 symptoms to CVST radiologic diagnosis was 11 days (interquartile range 6-16.75 days). Mortality was low in this cohort (1/8 or 12.5%). Clinicians should consider the risk of acute CVST in patients positive for COVID-19, especially if neurological symptoms develop.
Sections du résumé
BACKGROUND
BACKGROUND
COVID-19 infection has been known to predispose patients to both arterial and venous thromboembolic events such as deep venous thrombosis, pulmonary embolism, myocardial infarction, and stroke. A few reports from the literature suggest that Cerebral Venous Sinus Thrombosis (CVSTs) may be a direct complication of COVID-19.
OBJECTIVE
OBJECTIVE
To review the clinical and radiological presentation of COVID-19 positive patients diagnosed with CVST.
METHODS
METHODS
This was a multicenter, cross-sectional, retrospective study of patients diagnosed with CVST and COVID-19 reviewed from March 1, 2020 to November 8, 2020. We evaluated their clinical presentations, risk factors, clinical management, and outcome. We reviewed all published cases of CVST in patients with COVID-19 infection from January 1, 2020 to November 13, 2020.
RESULTS
RESULTS
There were 8 patients diagnosed with CVST and COVID-19 during the study period at 7 out of 31 participating centers. Patients in our case series were mostly female (7/8, 87.5%). Most patients presented with non-specific symptoms such as headache (50%), fever (50%), and gastrointestinal symptoms (75%). Several patients presented with focal neurologic deficits (2/8, 25%) or decreased consciousness (2/8, 25%). D-dimer and inflammatory biomarkers were significantly elevated relative to reference ranges in patients with available laboratory data. The superior sagittal and transverse sinuses were the most common sites for acute CVST formation (6/8, 75%). Median time to onset of focal neurologic deficit from initial COVID-19 diagnosis was 3 days (interquartile range 0.75-3 days). Median time from onset of COVID-19 symptoms to CVST radiologic diagnosis was 11 days (interquartile range 6-16.75 days). Mortality was low in this cohort (1/8 or 12.5%).
CONCLUSIONS
CONCLUSIONS
Clinicians should consider the risk of acute CVST in patients positive for COVID-19, especially if neurological symptoms develop.
Identifiants
pubmed: 33743411
pii: S1052-3057(21)00136-1
doi: 10.1016/j.jstrokecerebrovasdis.2021.105733
pmc: PMC7931726
pii:
doi:
Substances chimiques
Biomarkers
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
105733Commentaires et corrections
Type : CommentIn
Type : CommentIn
Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
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