Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
Clinical Neurology Research Center, Shiraz University of Medical Sciences, P.O.Box: 7193635899, Shiraz, Iran.
J Stroke Cerebrovasc Dis. 2022 Jul;31(7):106468. doi: 10.1016/j.jstrokecerebrovasdis.2022.106468. Epub 2022 Mar 25.
There are several reports of the association between SARS-CoV-2 infection (COVID-19) and cerebral venous sinus thrombosis (CVST). In this study, we aimed to compare the hospitalization rate of CVST before and during the COVID-19 pandemic (before vaccination program).
In this retrospective cohort study, the hospitalization rate of adult CVST patients in Namazi hospital, a tertiary referral center in the south of Iran, was compared in two periods of time. We defined March 2018 to March 2019 as the pre-COVID-19 period and March 2020 to March 2021 as the COVID-19 period.
50 and 77 adult CVST patients were hospitalized in the pre-COVID-19 and COVID-19 periods, respectively. The crude CVST hospitalization rate increased from 14.33 in the pre-COVID-19 period to 21.7 per million in the COVID-19 era (P = 0.021). However, after age and sex adjustment, the incremental trend in hospitalization rate was not significant (95% CrI: -2.2, 5.14). Patients > 50-year-old were more often hospitalized in the COVID-19 period (P = 0.042). SARS-CoV-2 PCR test was done in 49.3% out of all COVID-19 period patients, which were positive in 6.5%. Modified Rankin Scale (mRS) score ≥3 at three-month follow-up was associated with age (P = 0.015) and malignancy (P = 0.014) in pre-COVID period; and was associated with age (P = 0.025), altered mental status on admission time (P<0.001), malignancy (P = 0.041) and COVID-19 infection (P = 0.008) in COVID-19 period.
Since there was a more dismal outcome in COVID-19 associated CVST, a high index of suspicion for CVST among COVID-19 positive is recommended.
有几例报告表明严重急性呼吸综合征冠状病毒 2 感染（COVID-19）与脑静脉窦血栓形成（CVST）之间存在关联。在本研究中，我们旨在比较 COVID-19 大流行期间（疫苗接种计划之前）与之前相比 CVST 的住院率。
在这项回顾性队列研究中，我们比较了伊朗南部三级转诊中心纳马齐医院成年 CVST 患者在两个时间段的住院率。我们将 2018 年 3 月至 2019 年 3 月定义为 COVID-19 前时期，将 2020 年 3 月至 2021 年 3 月定义为 COVID-19 时期。
COVID-19 前时期和 COVID-19 时期分别有 50 例和 77 例成年 CVST 患者住院。未经年龄和性别调整的 CVST 住院率从 COVID-19 前时期的 14.33 例/百万人增加到 COVID-19 时期的 21.7 例/百万人（P=0.021）。然而，在调整年龄和性别后，住院率的递增趋势并不显著（95%CrI：-2.2，5.14）。年龄>50 岁的患者在 COVID-19 时期更常住院（P=0.042）。在所有 COVID-19 时期的患者中，有 49.3%进行了 SARS-CoV-2 PCR 检测，其中 6.5%呈阳性。COVID-19 前时期，3 个月随访时改良 Rankin 量表（mRS）评分≥3 与年龄（P=0.015）和恶性肿瘤（P=0.014）相关；而与年龄（P=0.025）、入院时精神状态改变（P<0.001）、恶性肿瘤（P=0.041）和 COVID-19 感染（P=0.008）相关在 COVID-19 时期。
由于 COVID-19 相关 CVST 的预后更差，建议对 COVID-19 阳性患者中 CVST 保持高度怀疑。
