RESUMO
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.
RESUMO
We share our experience of 2000 spinal tuberculosis (TB) cases, including both typical and atypical presentations. The aim of the study is to estimate the incidence and types of spinal TB referred to our department for diagnosis. 2000 patients were selected by convenience sampling from January 2006 to September 2010. Study design was descriptive and among 2000 mostly unknown cases without evidence of symptoms of systemic TB (1080 males and 920 females). MRI without and with IV contrast, CECT with MPR, and in some cases not fit for MRI, CT myelography, were performed. Out of 2000 cases of tuberculous spine, 1080 (54%) were male and 920 (46%) were female. Their age ranged from 8-60 years. About 90% of patients were below the age of 40 years. Peak age among the males and females was 20-29 years and 14-35 years, respectively. The most common site of involvement was dorsal spine (45%) followed by lumbo-sacral spine (33%), cervical spine (10%) and at multiple levels (12%). Biopsies were done in 240 (12%) cases. Spinal TB should always be suspected when radiographs demonstrate a destructive spinal process. Awareness and prompt management of TB spine will help in reducing the continuing morbidity of this disease.