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Cerebral Venous Thrombosis after ChAdOx1 nCoV-19 vaccination: a systematic review

journal contribution
posted on 2023-09-01, 14:57 authored by Song Tae-Jin, Jae Il Shin, Dong Keon Yon, Seung Won Lee, Soo Young Hwang, Jimin Hwang, Seung Hyun Park, Se Bee Lee, Min Ho Lee, Min Seo Kim, Ai Koyanagi, Kalthoum Tizaoui, Ji Hong Kim, Lee Smith
OBJECTIVE: To perform a systematic review of case reports or case series regarding thrombosis with thrombocytopenia syndrome (TTS) and cerebral venous thrombosis (CVT) related to ChAdOx1 nCoV-19 vaccination to address the clinical features, laboratory findings, treatment modalities, and prognosis related with CVT. SUBJECTS AND METHODS: We included 64 TTS patients from 19 articles, 6 case series and 13 case reports, in which thrombosis occurred after the first dose of ChAdOx1 nCoV-19 vaccination published up to 30 June 2021 in Embase, ePubs, Medline/PubMed, Scopus, and Web of Science databases. RESULTS: Of the 64 TTS patients, 38 (59.3%) had CVT. Patients with CVT were younger (median 36.5 vs. 52.5 years, p<0.001), had lower fibrinogen levels (130 vs. 245 mg/dL, p=0.008), had more frequent history of intracerebral hemorrhage (ICH), and had higher mortality rate (48.6% vs. 19.2%, p=0.020) than that of patients without CVT. In multivariable analysis, the possibility of presence of CVT was higher in younger age groups [odd ratio (OR): 0.91, 95% confidence interval (CI): (0.86-0.97, p<0.001)] and those with accompanying intracerebral hemorrhage (ICH) (OR: 13.60, 95% CI (1.28-144.12, p=0.045). CONCLUSIONS: Our study demonstrated that CVT related to ChAdOx1 nCoV-19 vaccination was associated with younger age, low levels of fibrinogen, presence of ICH and more frequent mortality compared to those of non-CVT. If TTS occurs after ChAdOx1 nCoV-19 vaccination, the presence of CVT in patients with young age or ICH should be considered.

History

Refereed

  • Yes

Volume

27

Page range

404-410

Publication title

European Review for Medical and Pharmacological Sciences

ISSN

2284-0729

Publisher

Verduci Editore

File version

  • Accepted version

Language

  • eng

Legacy posted date

2022-08-18

Legacy creation date

2022-08-18

Legacy Faculty/School/Department

COVID-19 Research Collection

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