Acute Arterial Ischemic Stroke Following COVID-19 Vaccination: A Systematic Review and Meta-analysis.


Journal

Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060

Informations de publication

Date de publication:
24 Aug 2022
Historique:
received: 04 02 2022
accepted: 08 06 2022
entrez: 24 8 2022
pubmed: 25 8 2022
medline: 25 8 2022
Statut: aheadofprint

Résumé

Acute arterial-ischemic-stroke (AIS) has been reported as a rare adverse-event following COVID-19-vaccination with mRNA or viral-vector vaccines. However, data are sparse regarding the risk of post-vaccination AIS and its potential association with thrombotic-thrombocytopenia-syndrome (TTS). A systematic review and meta-analysis of randomized-controlled clinical trials (RCTs), pharmacovigilance registries, registry-based studies, observational cohorts and case-series was performed with the aim to calculate: (1) the pooled proportion of patients presenting with AIS following COVID-19-vaccination; (2) the prevalence of AIS after mRNA and vector-based vaccination; (3) the proportion of TTS among post-vaccination AIS-cases. Patient characteristics were assessed as secondary outcomes. Two RCTs, three cohort and eleven registry-based studies comprising 17,481 AIS-cases among 782,989,363 COVID-19-vaccinations were included in the meta-analysis. The pooled proportion of AIS following exposure to any COVID-19-vaccine type was 4.7 cases per 100,000 vaccinations (95%CI:2.2-8.1; I The pooled proportion of AIS following COVID-19 vaccination is comparable to the prevalence of AIS in the general population and much lower than the AIS prevalence among SARS-CoV-2-infected patients. TTS is very uncommonly reported in patients with AIS following COVID-19 vaccination.

Sections du résumé

BACKGROUND BACKGROUND
Acute arterial-ischemic-stroke (AIS) has been reported as a rare adverse-event following COVID-19-vaccination with mRNA or viral-vector vaccines. However, data are sparse regarding the risk of post-vaccination AIS and its potential association with thrombotic-thrombocytopenia-syndrome (TTS).
METHODS METHODS
A systematic review and meta-analysis of randomized-controlled clinical trials (RCTs), pharmacovigilance registries, registry-based studies, observational cohorts and case-series was performed with the aim to calculate: (1) the pooled proportion of patients presenting with AIS following COVID-19-vaccination; (2) the prevalence of AIS after mRNA and vector-based vaccination; (3) the proportion of TTS among post-vaccination AIS-cases. Patient characteristics were assessed as secondary outcomes.
RESULTS RESULTS
Two RCTs, three cohort and eleven registry-based studies comprising 17,481 AIS-cases among 782,989,363 COVID-19-vaccinations were included in the meta-analysis. The pooled proportion of AIS following exposure to any COVID-19-vaccine type was 4.7 cases per 100,000 vaccinations (95%CI:2.2-8.1; I
CONCLUSIONS CONCLUSIONS
The pooled proportion of AIS following COVID-19 vaccination is comparable to the prevalence of AIS in the general population and much lower than the AIS prevalence among SARS-CoV-2-infected patients. TTS is very uncommonly reported in patients with AIS following COVID-19 vaccination.

Identifiants

pubmed: 36002319
pii: WNL.0000000000200996
doi: 10.1212/WNL.0000000000200996
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

© 2022 American Academy of Neurology.

Auteurs

Maria-Ioanna Stefanou (MI)

Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Lina Palaiodimou (L)

Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Diana Aguiar de Sousa (D)

Department of Neurosciences (Neurology), Hospital de Santa Maria, University of Lisbon, Lisbon, Portugal.

Aikaterini Theodorou (A)

Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Eleni Bakola (E)

Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Dimitrios Eleftherios Katsaros (DE)

Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Panagiotis Halvatsiotis (P)

Second Department of Internal Medicine-Propaedeutic and Diabetes Center, Medical School, University General Hospital 'Attikon', National and Kapodistrian University of Athens, Athens, Greece.

Elias Tzavellas (E)

First Department of Psychiatry, Aiginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Androniki Naska (A)

Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

Jonathan M Coutinho (JM)

Department of Neurology, Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Else Charlotte Sandset (EC)

Department of Neurology, Stroke Unit, Oslo University Hospital, Oslo, Norway.

Evangelos J Giamarellos-Bourboulis (EJ)

4th Department of Internal Medicine, National and Kapodistrian University of Athens, Medical School, Greece.

Georgios Tsivgoulis (G)

Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece tsivgoulisgiorg@yahoo.gr.
Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.

Classifications MeSH