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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.
J Stroke. 2022 May;24(2):256-265. doi: 10.5853/jos.2022.00752. Epub 2022 May 31.
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.
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).
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.
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.
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。
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）。
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。
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。
