2019冠状病毒病大流行对脑静脉血栓形成和死亡率的全球影响。
Global Impact of the COVID-19 Pandemic on Cerebral Venous Thrombosis and Mortality.
作者信息
Nguyen Thanh N, Qureshi Muhammad M, Klein Piers, Yamagami Hiroshi, Abdalkader Mohamad, Mikulik Robert, Sathya Anvitha, Mansour Ossama Yassin, Czlonkowska Anna, Lo Hannah, Field Thalia S, Charidimou Andreas, Banerjee Soma, Yaghi Shadi, Siegler James E, Sedova Petra, Kwan Joseph, de Sousa Diana Aguiar, Demeestere Jelle, Inoa Violiza, Omran Setareh Salehi, Zhang Liqun, Michel Patrik, Strambo Davide, Marto João Pedro, Nogueira Raul G, Kristoffersen Espen Saxhaug, Tsivgoulis Georgios, Lereis Virginia Pujol, Ma Alice, Enzinger Christian, Gattringer Thomas, Rahman Aminur, Bonnet Thomas, Ligot Noémie, De Raedt Sylvie, Lemmens Robin, Vanacker Peter, Vandervorst Fenne, Conforto Adriana Bastos, Hidalgo Raquel C T, Mora Cuervo Daissy Liliana, de Oliveira Neves Luciana, Lameirinhas da Silva Isabelle, Martíns Rodrigo Targa, Rebello Letícia C, Santiago Igor Bessa, Sakelarova Teodora, Kalpachki Rosen, Alexiev Filip, Cora Elena Adela, Kelly Michael E, Peeling Lissa, Pikula Aleksandra, Chen Hui-Sheng, Chen Yimin, Yang Shuiquan, Roje Bedekovic Marina, Čabal Martin, Tenora Dusan, Fibrich Petr, Dušek Pavel, Hlaváčová Helena, Hrabanovska Emanuela, Jurák Lubomír, Kadlčíková Jana, Karpowicz Igor, Klečka Lukáš, Kovář Martin, Neumann Jiří, Paloušková Hana, Reiser Martin, Rohan Vladimir, Šimůnek Libor, Skoda Ondreij, Škorňa Miroslav, Šrámek Martin, Drenck Nicolas, Sobh Khalid, Lesaine Emilie, Sabben Candice, Reiner Peggy, Rouanet Francois, Strbian Daniel, Boskamp Stefan, Mbroh Joshua, Nagel Simon, Rosenkranz Michael, Poli Sven, Thomalla Götz, Karapanayiotides Theodoros, Koutroulou Ioanna, Kargiotis Odysseas, Palaiodimou Lina, Barrientos Guerra José Dominguo, Huded Vikram, Nagendra Shashank, Prajapati Chintan, Sylaja P N, Sani Achmad Firdaus, Ghoreishi Abdoreza, Farhoudi Mehdi, Sadeghi Hokmabadi Elyar, Hashemilar Mazyar, Sabetay Sergiu Ionut, Rahal Fadi, Acampa Maurizio, Adami Alessandro, Longoni Marco, Ornello Raffaele, Renieri Leonardo, Romoli Michele, Sacco Simona, Salmaggi Andrea, Sangalli Davide, Zini Andrea, Sakai Kenichiro, Fukuda Hiroki, Fujita Kyohei, Imamura Hirotoshi, Kosuke Miyake, Sakaguchi Manabu, Sonoda Kazutaka, Matsumaru Yuji, Ohara Nobuyuki, Shindo Seigo, Takenobu Yohei, Yoshimoto Takeshi, Toyoda Kazunori, Uwatoko Takeshi, Sakai Nobuyuki, Yamamoto Nobuaki, Yamamoto Ryoo, Yazawa Yukako, Sugiura Yuri, Baek Jang-Hyun, Lee Si Baek, Seo Kwon-Duk, Sohn Sung-Il, Lee Jin Soo, Arsovska Anita Ante, Chieh Chan Yong, Wan Zaidi Wan Asyraf, Wan Yahya Wan Nur Nafisah, Gongora-Rivera Fernando, Martinez-Marino Manuel, Infante-Valenzuela Adrian, Dippel Diederik, van Dam-Nolen Dianne H K, Wu Teddy Y, Punter Martin, Adebayo Tajudeen Temitayo, Bello Abiodun H, Sunmonu Taofiki Ajao, Wahab Kolawole Wasiu, Sundseth Antje, Al Hashmi Amal M, Ahmad Saima, Rashid Umair, Rodriguez-Kadota Liliana, Vences Miguel Ángel, Yalung Patrick Matic, Dy Jon Stewart Hao, Brola Waldemar, Dębiec Aleksander, Dorobek Malgorzata, Karlinski Michal Adam, Labuz-Roszak Beata M, Lasek-Bal Anetta, Sienkiewicz-Jarosz Halina, Staszewski Jacek, Sobolewski Piotr, Wiącek Marcin, Zielinska-Turek Justyna, Araújo André Pinho, Rocha Mariana, Castro Pedro, Ferreira Patricia, Nunes Ana Paiva, Fonseca Luísa, Pinho E Melo Teresa, Rodrigues Miguel, Silva M Luis, Ciopleias Bogdan, Dimitriade Adela, Falup-Pecurariu Cristian, Hamid May Adel, Venketasubramanian Narayanaswamy, Krastev Georgi, Haring Jozef, Ayo-Martin Oscar, Hernandez-Fernandez Francisco, Blasco Jordi, Rodríguez-Vázquez Alejandro, Cruz-Culebras Antonio, Moniche Francisco, Montaner Joan, Perez-Sanchez Soledad, García Sánchez María Jesús, Guillán Rodríguez Marta, Bernava Gianmarco, Bolognese Manuel, Carrera Emmanuel, Churojana Anchalee, Aykac Ozlem, Özdemir Atilla Özcan, Bajrami Arsida, Senadim Songul, Hussain Syed I, John Seby, Krishnan Kailash, Lenthall Robert, Asif Kaiz S, Below Kristine, Biller Jose, Chen Michael, Chebl Alex, Colasurdo Marco, Czap Alexandra, de Havenon Adam H, Dharmadhikari Sushrut, Eskey Clifford J, Farooqui Mudassir, Feske Steven K, Goyal Nitin, Grimmett Kasey B, Guzik Amy K, Haussen Diogo C, Hovingh Majesta, Jillela Dinesh, Kan Peter T, Khatri Rakesh, Khoury Naim N, Kiley Nicole L, Kolikonda Murali K, Lara Stephanie, Li Grace, Linfante Italo, Loochtan Aaron I, Lopez Carlos D, Lycan Sarah, Male Shailesh S, Nahab Fadi, Maali Laith, Masoud Hesham E, Min Jiangyong, Orgeta-Gutierrez Santiago, Mohamed Ghada A, Mohammaden Mahmoud, Nalleballe Krishna, Radaideh Yazan, Ramakrishnan Pankajavalli, Rayo-Taranto Bliss, Rojas-Soto Diana M, Ruland Sean, Simpkins Alexis N, Sheth Sunil A, Starosciak Amy K, Tarlov Nicholas E, Taylor Robert A, Voetsch Barbara, Zhang Linda, Duong Hai Quang, Dao Viet-Phuong, Le Huynh Vu, Pham Thong Nhu, Ton Mai Duy, Tran Anh Duc, Zaidat Osama O, Machi Paolo, Dirren Elisabeth, Rodríguez Fernández Claudio, Escartín López Jorge, Fernández Ferro Jose Carlos, Mohammadzadeh Niloofar, Suryadevara Neil C, de la Cruz Fernández Beatriz, Bessa Filipe, Jancar Nina, Brady Megan, Scozzari Dawn
机构信息
Department of Neurology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.
出版信息
J Stroke. 2022 May;24(2):256-265. doi: 10.5853/jos.2022.00752. Epub 2022 May 31.
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.
背景与目的
近期研究表明，在2019年冠状病毒病（COVID-19）大流行期间，脑静脉血栓形成（CVT）的发病率有所上升。我们评估了COVID-19大流行第一年与前一年相比CVT的住院量及院内死亡率。
方法
我们对来自49个国家的171个卒中中心进行了一项横断面回顾性研究。我们记录了2019年1月1日至2021年5月31日期间的COVID-19入院量、CVT住院情况及CVT院内死亡率。CVT诊断通过国际疾病分类第10版（ICD-10）编码或卒中数据库确定。我们还试图比较2021年的前5个月与2019年和2020年相应月份的相同指标（ClinicalTrials.gov标识符：NCT04934020）。
结果
在大流行前一年（2019年）和大流行年（2020年）的1年期间，共有2313例CVT入院；未观察到CVT量或CVT死亡率的差异。与2019年（27.5%；95%置信区间[CI]，24.2至32.0；P<0.0001）和2020年（41.4%；95%CI，37.0至46.0；P<0.0001）相比，2021年的前5个月CVT量有所增加。在CVT住院患者中，7.6%（132/1738）被诊断为COVID-19。在COVID-19住院患者中，CVT的发生率为0.04%（103/292080）。在大流行的第一年，COVID-19阳性患者的CVT死亡率高于COVID-19阴性患者（8/53[15.0%]对41/910[4.5%]，P=0.004）。与大流行前一年2019年的前5个月相比，2020年和2021年大流行的前5个月CVT死亡率有所增加（2019年对2020年：2.26%对4.74%，P=0.05；2019年对2021年：2.26%对4.99%，P=0.03）。在2021年的前5个月，有26例疫苗诱导的免疫性血栓性血小板减少症（VITT）病例，导致6人死亡。
结论
在COVID-19大流行的第一年，与前一年相比，CVT住院量和CVT院内死亡率没有变化。COVID-19诊断与较高的CVT院内死亡率相关。在2021年的前5个月，CVT住院量增加，CVT相关死亡率增加，部分归因于VITT。
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