Cerebral Venous Thrombosis in COVID-19: A New York Metropolitan Cohort Study #MMPMID33888450
Al-Mufti F; Amuluru K; Sahni R; Bekelis K; Karimi R; Ogulnick J; Cooper J; Overby P; Nuoman R; Tiwari A; Berekashvili K; Dangayach N; Liang J; Gupta G; Khandelwal P; Dominguez JF; Sursal T; Kamal H; Dakay K; Taylor B; Gulko E; El-Ghanem M; Mayer SA; Gandhi C
AJNR Am J Neuroradiol 2021[Jul]; 42 (7): 1196-1200 PMID33888450show ga
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.
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AJNR+Am+J+Neuroradiol 2021 ; 42 (7): 1196-1200
