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Cerebral venous thrombosis and severe acute respiratory syndrome coronavirus-2 infection: A systematic review and meta-analysis.
Baldini, Tommaso; Asioli, Gian Maria; Romoli, Michele; Carvalho Dias, Mariana; Schulte, Eva C; Hauer, Larissa; Aguiar De Sousa, Diana; Sellner, Johann; Zini, Andrea.
  • Baldini T; IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurology and Metropolitan Stroke Center, "C.A. Pizzardi" Maggiore Hospital, Bologna, Italy.
  • Asioli GM; IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurology and Metropolitan Stroke Center, "C.A. Pizzardi" Maggiore Hospital, Bologna, Italy.
  • Romoli M; IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurology and Metropolitan Stroke Center, "C.A. Pizzardi" Maggiore Hospital, Bologna, Italy.
  • Carvalho Dias M; Neurology Clinic, University of Perugia-S. Maria della Misericordia Hospital, Perugia, Italy.
  • Schulte EC; Department of Neurosciences and Mental Health (Neurology), Hospital de Santa Maria/CHLN, University of Lisbon, Lisbon, Portugal.
  • Hauer L; Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Aguiar De Sousa D; Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
  • Sellner J; Institute of Virology, Technical University of Munich, Munich, Germany.
  • Zini A; Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
Eur J Neurol ; 28(10): 3478-3490, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1603703
ABSTRACT
BACKGROUND AND

PURPOSE:

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection predisposes patients to arterial and venous thrombosis. This study aimed to systematically review the available evidence in the literature for cerebral venous thrombosis (CVT) in association with coronavirus disease-2019 (COVID-19).

METHODS:

We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases to identify cases of COVID-19-associated CVT. The search period spanned 1 January 2020 to 1 December 2020, and the review protocol (PROSPERO-CRD42020214327) followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Identified studies were evaluated for bias using the Newcastle-Ottawa scale. A proportion meta-analysis was performed to estimate the frequency of CVT among hospitalized COVID-19 patients.

RESULTS:

We identified 57 cases from 28 reports. Study quality was mostly classified as low. CVT symptoms developed after respiratory disease in 90%, and the mean interval was 13 days. CVT involved multiple sites in 67% of individuals, the deep venous system was affected in 37%, and parenchymal hemorrhage was found in 42%. Predisposing factors for CVT beyond SARS-CoV-2 infection were present in 31%. In-hospital mortality was 40%. Using data from 34,331 patients, the estimated frequency of CVT among patients hospitalized for SARS-CoV-2 infection was 0.08% (95% confidence interval [CI] 0.01-0.5). In an inpatient setting, CVT accounted for 4.2% of cerebrovascular disorders in individuals with COVID-19 (cohort of 406 patients, 95% CI 1.47-11.39).

CONCLUSIONS:

Cerebral venous thrombosis in the context of SARS-CoV-2 infection is a rare, although there seems to be an increased relative risk. High suspicion is necessary, because the diagnosis of this potentially life-threatening condition in COVID-19 patients can be challenging. Evidence is still scarce on the pathophysiology and potential prevention of COVID-19-associated CVT.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Venous Thrombosis / Intracranial Thrombosis / COVID-19 Type of study: Cohort study / Etiology study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Eur J Neurol Journal subject: Neurology Year: 2021 Document Type: Article Affiliation country: Ene.14727

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Venous Thrombosis / Intracranial Thrombosis / COVID-19 Type of study: Cohort study / Etiology study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Eur J Neurol Journal subject: Neurology Year: 2021 Document Type: Article Affiliation country: Ene.14727