Cerebral Venous Thrombosis in Patients with COVID-19 Infection: a Case Series and Systematic Review.
J Stroke Cerebrovasc Dis
; 29(12): 105379, 2020 Dec.
Article
in English
| MEDLINE | ID: covidwho-816739
ABSTRACT
BACKGROUND:
There has been increasing reports associating the coronavirus disease 2019 (COVID-19) with thromboembolic phenomenon including ischemic strokes and venous thromboembolism. Cerebral venous thrombosis (CVT) is a rare neurovascular emergency that has been observed in some COVID-19 patients, yet much remains to be learnt of its underlying pathophysiology.OBJECTIVE:
We present a case series of local patients with concomitant COVID-19 infection and CVT; and aim to perform a systematic review of known cases in the current literature.METHODS:
We describe two patients with concomitant COVID-19 infection and CVT from a nationwide registry in Singapore. We then conducted a literature search in PubMed and Embase using a suitable keyword search strategy from 1st December 2019 to 11th June 2020. All studies reporting CVT in COVID-19 patients were included.RESULTS:
Nine studies and 14 COVID-19 patients with CVT were studied. The median age was 43 years (IQR=36-58) and majority had no significant past medical conditions (60.0%). The time taken from onset of COVID-19 symptoms to CVT diagnosis was a median of 7 days (IQR=6-14). CVT was commonly seen in the transverse (75.0%) and sigmoid sinus (50.0%); 33.3% had involvement of the deep venous sinus system. A significant proportion of patients had raised D-dimer (75.0%) and CRP levels (50.0%). Two patients reported presence of antiphospholipid antibodies. Most patients received anticoagulation (91.7%) while overall mortality rate was 45.5%.CONCLUSIONS:
The high mortality rate of CVT in COVID-19 infection warrants a high index of suspicion from physicians, and early treatment with anticoagulation should be initiated.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Sinus Thrombosis, Intracranial
/
Venous Thrombosis
/
COVID-19
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Topics:
Long Covid
Limits:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
J Stroke Cerebrovasc Dis
Journal subject:
Vascular Diseases
/
Brain
Year:
2020
Document Type:
Article
Affiliation country:
J.jstrokecerebrovasdis.2020.105379
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