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COVID and Vaccine-related Cerebral Venous Thrombosis

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The coronavirus disease-2019 (COVID-19) pandemic has been a major threat to global health. It primarily affects the respiratory system but multiple organs, including the nervous system, can be affected. Cerebral venous thrombosis (CVT) has been reported among COVID-19 patients as well as among recipients of COVID vaccines. CVT often remains a diagnostic challenge due to highly variable clinical presentation. We underwent a thorough narrative review of the published literature from January 2020 to April 2023 in the Medline (PubMed) database. Our search led to 66 studies in total, 30 related to COVID-CVT and 36 related to COVID vaccine-CVT. We further looked for differences between these COVID-CVT and COVID vaccine-associated-CVT and their possible pathophysiology, treatment options, and prognosis. A few things that were highlighted during our search: COVID increases CVT risk and can happen without respiratory manifestations. COVID-CVT is more common in middle-aged men and has a higher morality compared to traditional non-COVID-CVT. COVID vaccines also increase the risk of CVT but less than the COVID infection. COVID vaccine-CVT is further divided into two groups having either normal platelets or low platelets. The latter group is better reported and has a higher inpatient mortality and disability at discharge but these patients usually recover well in the follow-up period. Non-heparin anticoagulation, immunomodulation, and surgery are the main treatment options.
Title: COVID and Vaccine-related Cerebral Venous Thrombosis
Description:
The coronavirus disease-2019 (COVID-19) pandemic has been a major threat to global health.
It primarily affects the respiratory system but multiple organs, including the nervous system, can be affected.
Cerebral venous thrombosis (CVT) has been reported among COVID-19 patients as well as among recipients of COVID vaccines.
CVT often remains a diagnostic challenge due to highly variable clinical presentation.
We underwent a thorough narrative review of the published literature from January 2020 to April 2023 in the Medline (PubMed) database.
Our search led to 66 studies in total, 30 related to COVID-CVT and 36 related to COVID vaccine-CVT.
We further looked for differences between these COVID-CVT and COVID vaccine-associated-CVT and their possible pathophysiology, treatment options, and prognosis.
A few things that were highlighted during our search: COVID increases CVT risk and can happen without respiratory manifestations.
COVID-CVT is more common in middle-aged men and has a higher morality compared to traditional non-COVID-CVT.
COVID vaccines also increase the risk of CVT but less than the COVID infection.
COVID vaccine-CVT is further divided into two groups having either normal platelets or low platelets.
The latter group is better reported and has a higher inpatient mortality and disability at discharge but these patients usually recover well in the follow-up period.
Non-heparin anticoagulation, immunomodulation, and surgery are the main treatment options.

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