J Stroke.  2022 May;24(2):256-265. 10.5853/jos.2022.00752.

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

Affiliations
  • 1Department of Neurology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
  • 2Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
  • 3Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
  • 4Department of Stroke Neurology, National Hospital Organization, Osaka National Hospital, Osaka, Japan
  • 5Department of Neurology, International Clinical Research Center, St. Anne’s University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
  • 6Department of Neurology, Alexandria University, Alexandria, Egypt
  • 72nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
  • 8Division of Neurology, Dept. Medicine, University of British Columbia, Vancouver, BC, Canada
  • 9Department of Stroke Medicine, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK
  • 10Department of Neurology, Rhode Island Hospital, Brown University, Providence, RI, USA
  • 11Department of Neurology, Cooper University, Camden, NJ, USA
  • 12Department of Neurology, Hospital de Santa Maria, North Lisbon University Hospital Center (CHULN), Lisbon, Portugal
  • 13Neurology Department, Leuven University Hospital, Leuven, Belgium
  • 14Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
  • 15Department of Neurology, University of Colorado School of Medicine, Aurora, CO, USA
  • 16Department of Neurology St George’s University Hospital, London, UK
  • 17Department of Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
  • 18Department of Neurology, Egas Moniz Hospital, West Lisbon Hospital Center (CHLO), Lisbon, Portugal
  • 19Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
  • 20Department of Neurology, Radiology, Boston Medical Center, Boston University School of Medicine, Boston, USA
  • 21Department of Radiology, Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, USA
  • 22Department of Stroke Neurology, National Hospital Organization, Osaka National Hospital, Osaka, Japan
  • 23Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, USA
  • 24Department of Neurology, International Clinical Research Centre, St Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
  • 25Department of Neurology, Alexandria University Stroke and Neurointervention Unit, Alexandria, Egypt
  • 262nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
  • 27Department of Medicine, Division of Neurology, University of British Columbia, Vancouver, Canada
  • 28Department of Neurology, Rhode Island Hospital, Brown University, Providence, USA
  • 29Department of Neurology, Cooper Neurological Institute, Cooper University Hospital, Camden, USA
  • 30Department of Neurology, Boston Medical Center, Boston University School of Medicine, Boston, USA
  • 31Department of Stroke Medicine, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
  • 32Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic
  • 33Department of Neurology, Akershus University Hospital, University of Oslo, Lørenskog, Norway
  • 34Department of General Practice, University of Oslo, Oslo, Norway
  • 35Hospital de Santa Maria - CHULN, Lisbon, Portugal
  • 36Neurology Department, Leuven University Hospital, Leuven, Belgium
  • 37University of Tennessee Health Science Center, Memphis, USA
  • 38University of Colorado School of Medicine, Aurora, USA
  • 39St George's University Hospital, London, UK
  • 40"Attikon" University Hospital, National and Kapodistrian University of Athens, Athens, Greece
  • 41Division de Neurologia Vascular, Departmento de Neurologia, Institute for Neurological Research - FLENI, Buenos Aires, Argentina
  • 42Royal North Shore Hospital, Sydney, Australia
  • 43Department of Neurology, Medical University of Graz, Graz, Austria
  • 44Department of Neurology and Division of Neuroradiology, Vascular and Interventional Radiology, Medical University of Graz, Graz, Austria
  • 45Department of Neurology, Sir Salimullah Medical College, Mitford, Dhaka, Bangladesh
  • 46Hopital Erasme, Brussels, Belgium
  • 47Department of Neurology, Universitair Ziekenhuis Brussel, Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
  • 48Department of Neurology, University Hospitals Antwerp, Antwerp, Belgium
  • 49Department of Translational Neuroscience, University of Antwerp, Belgium
  • 50Hospital das Clínicas, São Paulo University, São Paulo , Brazil
  • 51Department of Neurology and Interventional Neuroradiology, Hospital de Base de São José do Rio Preto, São Paulo, Brazil
  • 52Moinhos de Vento Hospital, Brazil, Porto Alegre, Brazil
  • 53Hospital São Carlos, Brazil, Fortaleza, Brazil
  • 54Stroke Unit, Neurology, Nossa Senhora da Conceição Hospital, Porto Alegre, Brazil
  • 55Hospital de Base do Distrito Federal, Brasilia, Brazil
  • 56St. Anna University Hospital, Sofia, Bulgaria
  • 57Department of Diagnostic Radiology, Halifax Infirmary, Dalhousie University, Halifax, Canada
  • 58Royal University Hospital, Saskatoon, Canada
  • 59Toronto Western Hospital, University of Toronto, Toronto, Canada
  • 60Department of Neurology, General Hospital of Northern Theater Command, Shen Yang, China
  • 61Department of Neurology, Foshan Sanshui District People's Hospital, Foshan, China
  • 62Department of Neurology, Sestre Milosrdnice University Hospital Center, Croatia, Zagreb, Croatia
  • 63Department of Neurology, Faculty Hospital Ostrava, Ostrava, Czech Republic
  • 64Department of Neurology, Blansko Hospital, Czech Republic, Blansko, Czech Republic
  • 65Oblastní nemocnice Trutnov a.s., Trutnov, Czech Republic
  • 66Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
  • 67Neurology, Hospital Příbram, Příbram, Czech Republic
  • 68Uherskohradišťská Hospital, Uherské Hradiště, Czech Republic
  • 69Neurocenter, Regional Hospital Liberec, Liberec, Czech Republic
  • 70Neurology, Hospital Vyskov, Vyskov, Czech Republic
  • 71Regional Hospital Karlovy Vary, Karlovy Vary, Czech Republic
  • 72Municipal Hospital Ostrava, Ostrava, Czech Republic
  • 73Na Homolce Hospital, Prague, Czech Republic
  • 74Department of Neurology, Krajská zdravotní-Hospital Chomutov, Chomutov, Czech Republic
  • 75Karvina Mining Hospital, Czech Republic, Karvina, Czech Republic
  • 76Neurology, České Budejovice Hospital, České Budějovice, Czech Republic
  • 77Department of Neurology, University Hospital Plzen, Plzen, Czech Republic
  • 78Department of Neurology, Comprehensive Stroke Center, Charles University Faculty of Medicine and University Hospital, Hradec Kralove, Czech Republic
  • 79Department of Neurology, Hospital Jihlava, Jihlava, Czech Republic
  • 80Department of Neurology, Masaryk University Faculty of Medicine, University Hospital Brno, Brno, Czech Republic
  • 81Central Military Hospital in Prague, Prague, Czech Republic
  • 82Copenhagen University Hospital, Copenhagen, Denmark
  • 83El hussein Alzahar University Hospital, Cairo, Egypt
  • 84Centre Hospitalier de l'Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, CIC-EC 14-01, Bordeaux, France
  • 85Department of Neurology, Rothschild Foundation Hospital, Paris, France
  • 86Lariboisiere Hospital, Paris, France
  • 87Bordeaux University Hospital Neurology, Stroke Unit, Bordeaux, France
  • 88Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
  • 89Department of Neurology, Albertinen Krankenhaus, Hamburg, Germany
  • 90Department of Neurology & Stroke, Eberhard-Karls University, Tuebingen, Germany
  • 91Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tuebingen, Germany
  • 92Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen/Rhein, Germany
  • 93Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
  • 94Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Neurologie, Hamburg, Germany
  • 952nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, School of Medicine, Faculty of Health Sciences, Thessaloniki, Greece
  • 96Stroke Unit, Metropolitan Hospital, Piraeus, Greece
  • 97Hospital General San Juan de Dios, Guatemala City, Guatemala
  • 98Mazumdar Shaw Medical Center, Bangalore, India
  • 99Department of Neurology, Grant Medical College and Sir JJ Hospital, Mumbai, India
  • 100Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
  • 101Dr. Soetomo General Hospital Surabaya, Universitas Airlangga, Surabaya, Indonesia
  • 102Department of Neurology, Vali-e-Asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
  • 103Neurosciences Research Center, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
  • 104Neurosciences Research Center, Razi Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
  • 105Neurology Department, Hillel Yaffe Medical Center, Hadera, Israel
  • 106Hillel Yaffe Medical Center, Hadera, Israel
  • 107Stroke Unit, University of Siena, Siena, Italy
  • 108Stroke Center IRCCS Sacro Cuore Don Calabria, Verona, Italy
  • 109Neurology and Stroke Unit, Ospedale Bufalini, Cesena, Italy
  • 110Neuroscience Section, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
  • 111Interventional Neurovascular Unit, Careggi University Hospital, Florence, Italy
  • 112Neurology and Stroke Unit, Department of Neuroscience, Bufalini Hospital, Cesena, Italy
  • 113Neurological Department, "Alessandro Manzoni" Hospital, ASST Lecco, Via dell'Eremo 9/11, Lecco, Italy
  • 114IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurologia e Rete Stroke Metropolitana, Bologna, Italy
  • 115Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan
  • 116Department of Neurology, Japanese Red Cross Matsue Hospital, Matsue, Japan
  • 117Department of Endovascular Surgery, Tokyo Medical and Dental University, Tokyo, Japan
  • 118Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
  • 119Shiroyama Hospital, Shiroyama, Japan
  • 120Department of Neurology, Osaka General Medical Center, Osaka, Japan
  • 121Department of Neurology, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
  • 122Department of Stroke and Cerebrovascular Diseases, University of Tsukuba Hospital, Tskukuba, Japan
  • 123Department of Neurology, Kobe City Medical Center General Hospital, Kobe City, Japan
  • 124Department of Neurology, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan
  • 125Osaka Red Cross Hospital, Osaka, Japan
  • 126Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
  • 127Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
  • 128Cerebrovascular Medicine, Stroke Center, Saga Medical Centre Koseikan, Saga, Japan
  • 129Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe City, Japan
  • 130Advanced Brain Research, Tokushima University, Tokushima, Japan
  • 131Yokohama Brain and Spine Center, Yokohama, Japan
  • 132Department of Stroke Neurology, Kohnan Hospital, Sendai, Japan
  • 133Toyonaka Municipal Hospital, Toyonaka, Japan
  • 134Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
  • 135Department of Neurology, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, South Korea
  • 136Department of Neurology, National Health Insurance Service Ilsan Hospital, Goyang, South Korea
  • 137Department of Neurology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, South Korea
  • 138Department of Neurology, Ajou University Hospital, Ajou, South Korea
  • 139Department of Urgent Neurology, University Clinic of Neurology, University Ss. Cyril and Methodius-Faculty of Medicine, Skopje, North Macedonia
  • 140Hospital Sultan Abdul Halim, Sungai Petani, Malaysia
  • 141Department of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
  • 142Department of Medicine, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
  • 143Neurovascular Unit and Neurology Department, University Hospital Jose Eleuterio Gonzalez, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
  • 144Department of Neurology, Hospital de especialidades del Centro Médico Nacional Siglo XXI IMSS, Mexico City, Mexico
  • 145Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  • 146Department of Neurology, Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
  • 147Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
  • 148Wellington Regional Hospital, Capital and Coast District Health Board, Wellington, New Zealand
  • 149Department of Medicine, University of Otago, Wellington
  • 150Department of Medical Records, Federal Medical Centre, Owo, Nigeria
  • 151Neurology Unit, University of Ilorin, Ilorin, Nigeria
  • 152Department of Medicine, Federal Medical Centre Owerri, Neurology Unit, Federal Medical Centre, Owerri, Nigeria
  • 153Department of Neurology, Akershus University Hospital, Lørenskog, Norway
  • 154Central Stroke Unit, Neuroscience Directorate, Khoula Hospital, Ministry of Health, Muscat, Oman
  • 155Lahore General Hospital, Lahore, Pakistan
  • 156Departamento de Neurología, Hospital Nacional Edgardo Rebagliati Martins, Essalud, Lima, Peru
  • 157St. Luke's Medical Center, Global City, Philippines
  • 158St. Luke's Medical Center, Quezon City, Philippines
  • 159Department of Neurology, Specialist Hospital Konskie, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
  • 160Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland
  • 161Department of Neurology, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland
  • 162Department of Neurology, St. Jadwiga Provincial Specialist Hospital in Opole, Institute of Medical Sciences, University of Opole, Opole, Poland
  • 163Department of Neurology, Leszek Giec Upper Silesian Medical Centre of the Silesian Medical University in Katowice, School of Health Sciences, Medical University of Silesia in Katowice, Katowice, Poland
  • 1641st Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland
  • 165Clinic of Neurology, Military Institute of Medicine, Szasero 128, Warsaw, Poland
  • 166Department of Neurology in Sandomierz, Collegium Medicum, Jan Kochanowski University in Kielce, Sandomierz, Poland
  • 167Department of Neurology, Institute of Medical Sciences, Medical College of Rzeszow University, Rzeszow, Poland
  • 168Department of Neurology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland
  • 169Department of Neurology, Central Clinical Hospital of the Ministry of Internal Affairs and Administration, Warsaw, Poland
  • 170Neuroradiology Department - Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  • 171Neurology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
  • 172Department of Neurology, Centro Hospitalar Universitário de São João, Porto, Portugal
  • 173Stroke Unit, Centro Hospitalar Universitário de Lisboa Central, Lisbon, Portugal
  • 174Stroke Unit, Medicine Department, Centro Hospitalar Universitário de São João, Porto, Portugal
  • 175Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Lisbon, Portugal
  • 176Department of Neurology, Hospital Garcia de Orta, Almada, Portugal
  • 177Centro Hospitalar Universitário de São João, Porto, Portugal
  • 178County Emergency Clinic Hospital Brasov, Brasov, Romania
  • 179Bucharest University Emergency Hospital, Bucharest, Romania
  • 180Department of Neurology, County Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania
  • 181Department of Neurology King Fahad Hospital of the University Imam Abdulrahman bin Faisal University Dammam, Dammam, Saudi Arabia
  • 182Raffles Hospital, Singapore, Singapore
  • 183Department of Neurology, Faculty Hospital Trnava, Trnava, Slovakia
  • 184Jessenius Medical Faculty, Martin, Commenius University, Bratislava, Slovakia
  • 185Department of Neurology, Slovak Medical University, Bratislava, Slovakia
  • 186Complejo Hospitalario Universitario de Albacete, Albacete, Spain
  • 187Interventional Neuroradiology, Hospital Clinic de Barcelona, Barcelona, Spain
  • 188Comprehensive Stroke Center, Hospital Clínic de Barcelona, Barcelona, Spain
  • 189Department of Neurology (Unidad de Ictus), Hospital Universitario Ramón y Cajal, Madrid, Spain
  • 190Stroke Unit, Neurology Department, Hospital Universitario Virgen del Rocío, Seville, Spain
  • 191Department of Neurology, Hospital Universitario Virgen Macarena , Seville, Spain
  • 192Neurovascular Research Laboratory, Instituto de Biomedicina de Sevilla-IbiS
  • 193Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain
  • 194Department of Neuroradiology, Hospital Universitario Rey Juan Carlos, Madrid, Spain
  • 195Department of Neurology, Hospital Universitario Rey Juan Carlos, Madrid, Spain
  • 196Interventional Neuroradiology, University Hospitals of Geneva, Geneva, Switzerland
  • 197Neurocenter, Cantonal Hospital of Lucerne, Lucerne, Switzerland
  • 198Department of Neurology, University Hospitals of Geneva, Geneva, Switzerland
  • 199Department of Radiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • 200Eskisehir Osmangazi University, Eskisehir, Turkey
  • 201Istanbul Aydın University, Florya Medicalpark Stroke Center, Istanbul, Turkey
  • 202Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arabe Emirates
  • 203Stroke, Department of Medicine, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
  • 204Neuroradiology, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom
  • 205Amita Health and University of Illinois-Chicago, Chicago, United States
  • 206Neuroscience and Stroke Program, Bon Secours Mercy Health St Vincent Hospital, Toledo, United States
  • 207Loyola University Chicago Stritch School of Medicine, Maywood, United States
  • 208Rush University Medical Center, Chicago, United States
  • 209Department of Neurology, Henry Ford Health System, Detroit, United States
  • 210Department of Radiology, University of Texas Medical Branch, Galveston, United States
  • 211Neurology, McGovern Medical School at the University of Texas Health Science Center, Houston, United States
  • 212University of Utah, Salt Lake City, United States
  • 213Baptist Health Medical Center - Little Rock, Little Rock, United States
  • 214Dartmouth Hitchcock Medical Center, Lebanon, United States
  • 215University of Iowa, Iowa City, United States
  • 216Neurology, Boston Medical Center, Boston, United States
  • 217University of Tennessee Health Science Center, Memphis, United States
  • 218Department of Neurology, Wake Forest Baptist Medical Center, Winston-Salem, United States
  • 219Department of Neurology, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, United States
  • 220Department of Neurosciences and Comprehensive Stroke Center, Spectrum Health and Michigan State University College of Human Medicine, Grand Rapids, United States
  • 221Department of Neurosurgery, University of Texas Medical Branch, Galveston, United States
  • 222Department of Neurology, Texas Tech University Health Science Center, El Paso, United States
  • 223HSHS St. John's Hospital, Southern Illinois University School of Medicine, Springfield, United States
  • 224Department of Radiology, Boston Medical Center, Boston, United States
  • 225Baptist Health Medical Group, Baptist Health Lexington, Lexington, United States
  • 226Community Memorial Hospital, Ventura, United States
  • 227University of Florida, Gainesfille, United States
  • 228Miami Cardiac & Vascular Institute, Miami Neuroscience Institute, Miami, United States
  • 229Ohio Health Riverside Methodist Hospital, Columbus, United States
  • 230SUNY Upstate New York, Syracuse, United States
  • 231Department of Neurology & Neurosurgery, Vidant Medical Center, Greenville, United States
  • 232Department of Neurology, Pediatrics, Emory University, Atlanta, United States
  • 233Department of Neurology, University of Kansas Medical Center, Kansas City, United States
  • 234Department of Neurology, SUNY Upstate, Syracuse, United States
  • 235Department of Neurosciences and Comprehensive Stroke Center, Spectrum Health and Michigan State University, Grand Rapids, United States
  • 236University of Iowa, Iowa, USA, Iowa City, United States
  • 237Department of Neurology, Emory University, Atlanta, USA
  • 238Department of Neurology, Emory University School of Medicine, Atlanta, United States
  • 239Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, United States
  • 240Riverside Regional Medical Center, Newport News, United States
  • 241Santa Barbara Cottage Hospital, Santa Barbara, United States
  • 242Department of Neurology, University of Florida, Gainesville, United States
  • 243Miami Neuroscience Institute, Miami, United States
  • 244Department of Neurology, Lahey Health, Burlington, United States
  • 245Cooper Neurological Institute, Camden, United States
  • 246Da Nang Hospital, Da Nang, Vietnam
  • 247Bach Mai Hospital, Hanoi, Vietnam
  • 248Hue Central, Hue, Vietnam
  • 249Department of Neurology, Hospital de Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal
  • 250Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
  • 251Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, United States
  • 252Geneva
  • 253Hospital Universitario rey Juan Carlos, Spain
  • 254Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
  • 255SUNY Upstate, New York, USA
  • 256Geneva University Hospitals, Geneva, Switzerland
  • 257Hospital de Santa Maria - Centro Hospitalar Lisboa Norte, Portugal
  • 258Department of Neurology, SUNY Upstate, Syracuse, New York, USA
  • 259Department of Neurology, Henry Ford Health System, Detroit, Michigan, USA

Abstract

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.

Keyword

COVID-19; Cerebral venous thrombosis; Vaccine-induced immune thrombotic thrombocytopenia; Mortality; SARS-CoV-2; Stroke

Figure

  • Figure 1. Study flow chart. CVT, cerebral venous thrombosis; SAH, subarachnoid hemorrhage; COVID-19, coronavirus disease 2019.

  • Figure 2. Cerebral venous thrombosis (CVT), CVT mortality, and coronavirus disease 2019 (COVID-19) admissions. CVT admissions are based on data submitted from 171 centers. COVID-19 admissions are based on data submitted from 154/171 centers.

  • Figure 3. Cerebral venous thrombosis (CVT) in-hospital mortality rate during the first 5 months of three different year (2019, 2020, 2021) comparisons in 138 hospitals with complete CVT mortality and CVT admission data. CVT in-hospital mortality 2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; CVT in-hospital mortality 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03; CVT in-hospital mortality 2020 vs. 2021, no difference. *Twenty-six vaccine-induced immune thrombotic thrombocytopenia (VITT) probable or confirmed cases were identified in 2021, resulting in six deaths. Excluding cases of confirmed or probable VITT, the case fatality rate of CVT during the first 5 months of 2021 drops from 4.99% to 4.04% (20/495 CVT cases) (P=0.1).


Reference

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