tetano
Editor, Senior Moderator
AJNR Am J Neuroradiol
. 2021 Apr 22.
doi: 10.3174/ajnr.A7134. Online ahead of print.
Cerebral Venous Thrombosis in COVID-19: A New York Metropolitan Cohort Study
F Al-Mufti[SUP] 1 2 [/SUP], K Amuluru[SUP] 3 [/SUP], R Sahni[SUP] 4 2 [/SUP], K Bekelis[SUP] 5 [/SUP], R Karimi[SUP] 6 [/SUP], J Ogulnick[SUP] 2 [/SUP], J Cooper[SUP] 4 [/SUP], P Overby[SUP] 4 [/SUP], R Nuoman[SUP] 4 [/SUP], A Tiwari[SUP] 7 [/SUP], K Berekashvili[SUP] 7 [/SUP], N Dangayach[SUP] 8 [/SUP], J Liang[SUP] 8 [/SUP], G Gupta[SUP] 9 [/SUP], P Khandelwal[SUP] 9 [/SUP], J F Dominguez[SUP] 4 [/SUP], T Sursal[SUP] 4 [/SUP], H Kamal[SUP] 2 [/SUP], K Dakay[SUP] 2 [/SUP], B Taylor[SUP] 9 [/SUP], E Gulko[SUP] 4 2 [/SUP], M El-Ghanem[SUP] 10 [/SUP], S A Mayer[SUP] 4 2 [/SUP], C Gandhi[SUP] 4 2 [/SUP]
Affiliations
Abstract
Background and purpose: Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is associated with hypercoagulability. We sought to evaluate the demographic and clinical characteristics of cerebral venous thrombosis among patients hospitalized for coronavirus disease 2019 (COVID-19) at 6 tertiary care centers in the New York City metropolitan area.
Materials and methods: We conducted a retrospective multicenter cohort study of 13,500 consecutive patients with COVID-19 who were hospitalized between March 1 and May 30, 2020.
Results: Of 13,500 patients with COVID-19, twelve had imaging-proved cerebral venous thrombosis with an incidence of 8.8 per 10,000 during 3 months, which is considerably higher than the reported incidence of cerebral venous thrombosis in the general population of 5 per million annually. There was a male preponderance (8 men, 4 women) and an average age of 49 years (95% CI, 36-62 years; range, 17-95 years). Only 1 patient (8%) had a history of thromboembolic disease. Neurologic symptoms secondary to cerebral venous thrombosis occurred within 24 hours of the onset of the respiratory and constitutional symptoms in 58% of cases, and 75% had venous infarction, hemorrhage, or both on brain imaging. Management consisted of anticoagulation, endovascular thrombectomy, and surgical hematoma evacuation. The mortality rate was 25%.
Conclusions: Early evidence suggests a higher-than-expected frequency of cerebral venous thrombosis among patients hospitalized for COVID-19. Cerebral venous thrombosis should be included in the differential diagnosis of neurologic syndromes associated with SARS-CoV-2 infection
. 2021 Apr 22.
doi: 10.3174/ajnr.A7134. Online ahead of print.
Cerebral Venous Thrombosis in COVID-19: A New York Metropolitan Cohort Study
F Al-Mufti[SUP] 1 2 [/SUP], K Amuluru[SUP] 3 [/SUP], R Sahni[SUP] 4 2 [/SUP], K Bekelis[SUP] 5 [/SUP], R Karimi[SUP] 6 [/SUP], J Ogulnick[SUP] 2 [/SUP], J Cooper[SUP] 4 [/SUP], P Overby[SUP] 4 [/SUP], R Nuoman[SUP] 4 [/SUP], A Tiwari[SUP] 7 [/SUP], K Berekashvili[SUP] 7 [/SUP], N Dangayach[SUP] 8 [/SUP], J Liang[SUP] 8 [/SUP], G Gupta[SUP] 9 [/SUP], P Khandelwal[SUP] 9 [/SUP], J F Dominguez[SUP] 4 [/SUP], T Sursal[SUP] 4 [/SUP], H Kamal[SUP] 2 [/SUP], K Dakay[SUP] 2 [/SUP], B Taylor[SUP] 9 [/SUP], E Gulko[SUP] 4 2 [/SUP], M El-Ghanem[SUP] 10 [/SUP], S A Mayer[SUP] 4 2 [/SUP], C Gandhi[SUP] 4 2 [/SUP]
Affiliations
- PMID: 33888450
- DOI: 10.3174/ajnr.A7134
Abstract
Background and purpose: Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is associated with hypercoagulability. We sought to evaluate the demographic and clinical characteristics of cerebral venous thrombosis among patients hospitalized for coronavirus disease 2019 (COVID-19) at 6 tertiary care centers in the New York City metropolitan area.
Materials and methods: We conducted a retrospective multicenter cohort study of 13,500 consecutive patients with COVID-19 who were hospitalized between March 1 and May 30, 2020.
Results: Of 13,500 patients with COVID-19, twelve had imaging-proved cerebral venous thrombosis with an incidence of 8.8 per 10,000 during 3 months, which is considerably higher than the reported incidence of cerebral venous thrombosis in the general population of 5 per million annually. There was a male preponderance (8 men, 4 women) and an average age of 49 years (95% CI, 36-62 years; range, 17-95 years). Only 1 patient (8%) had a history of thromboembolic disease. Neurologic symptoms secondary to cerebral venous thrombosis occurred within 24 hours of the onset of the respiratory and constitutional symptoms in 58% of cases, and 75% had venous infarction, hemorrhage, or both on brain imaging. Management consisted of anticoagulation, endovascular thrombectomy, and surgical hematoma evacuation. The mortality rate was 25%.
Conclusions: Early evidence suggests a higher-than-expected frequency of cerebral venous thrombosis among patients hospitalized for COVID-19. Cerebral venous thrombosis should be included in the differential diagnosis of neurologic syndromes associated with SARS-CoV-2 infection