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.; Cabal, M.; Tenora, D.; Dusek, P.; Fibrich, P.; Hrabanovska, E.; Hlavacova, H.; Jurak, L.; Kadlckova, J.; Karpowicz, I.; Klecka, L.; Kovar, M.; Neumann, J.; Palouskova, H.; Reiser, M.; Rohan, V.; Skoda, O.; Skorna, M.; Simunek, L.; Sramek, 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.; T. Y., Wu; 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. A.; Yalung, P. M.; Brola, W.; Debiec, A.; Dorobek, M.; Karlinski, M. A.; Labuz-Roszak, B. M.; Lasek-Bal, A.; Sienkiewicz-Jarosz, H.; Staszewski, J.; Sobolewski, P.; Wiacek, M.; Zielinska-Turek, J.; Araujo, 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.; Sanchez, M. J. G.; Montaner, J.; Perez-Sanchez, S.; Rodriguez-Vazquez, 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.; Fernandez, C. R.; Lopez, J. E.; Ferro, J. C. F.; Mohammadzadeh, N.; Suryadevara, N. C.; Jancar, N.

doi:10.5853/jos.2022.00752

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.