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Outcomes of Cerebral Venous Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia After the Acute Phase

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机构: [1]Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Neurol, Amsterdam, Netherlands [2]Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Vasc Med, Amsterdam, Netherlands [3]Sahlgrens Univ Hosp, Dept Neurol, Gothenburg, Sweden [4]Univ Gothenburg, Sahlgrenska Acad, Inst Neurosci & Physiol, Dept Clin Neurosci, Gothenburg, Sweden [5]Royal Adelaide Hosp, Dept Neurol, Adelaide, SA, Australia [6]Univ British Columbia, Div Neurol, Vancouver Stroke Program, Vancouver, BC, Canada [7]Univ Lille, Inserm, CHU Lille, U1172 LiINCog Lille Neurosci & Cognit, Lille, France [8]Univ Hosp Tuebingen, Dept Neurol & Stroke, Tubingen, Germany [9]Eberhard Karls Univ Tubingen, Hertie Inst Clin Brain Res, Tubingen, Germany [10]Shiraz Univ Med Sci, Clin Neurol Res Ctr, Shiraz, Iran [11]Univ Hosp Leuven, Dept Neurol, Leuven, Belgium [12]Univ Bern, Inselspital, Bern Univ Hosp, Dept Neurol, Bern, Switzerland [13]Univ Bern, Inselspital, Bern Univ Hosp, Dept Hematol, Bern, Switzerland [14]Azienda Socio Sanitaria Terr Mantova, Carlo Poma Hosp, Dept Neurol, Mantua, Italy [15]Med Univ Graz, Dept Neurol, Graz, Austria [16]Univ Hosp Rostock, Dept Neurol, Rostock, Germany [17]Saudi German Hosp, Dept Neurol, Jeddah, Saudi Arabia [18]Jena Univ Hosp, Dept Neurol, Jena, Germany [19]Royal Darwin Hosp, Darwin, NT, Australia [20]John Hunter Hosp, Dept Neurol, Newcastle, NSW, Australia [21]Univ Alberta Hosp, Div Neurol, Edmonton, AB, Canada [22]Azienda Osped Melegnano & Martesana, Dept Neurol, Melegnano, MI, Italy [23]Krankenhaus NW Frankfurt, Dept Neurol, Frankfurt, Germany [24]Hosp Gen Castellon, Dept Neurol, Castellon de La Plana, Spain [25]Leipzig Univ Hosp, Dept Neurol, Leipzig, Germany [26]Iran Univ Med Sci, Sch Med, Firoozabadi Hosp, Dept Neurol, Tehran, Iran [27]Iran Univ Med Sci, Sch Med, Firoozgar Hosp, Dept Neurol, Tehran, Iran [28]Ottawa Hosp, Div Neurol, Ottawa, ON, Canada [29]Umea Univ, Dept Clin Sci, Wallenberg Ctr Mol Med WCMM, Umea, Sweden [30]Univ Hosp del Mar, Dept Neurol, Barcelona, Spain [31]Univ Hosp Besancon, Stroke Unit, Besancon, France [32]Univ Klinikum Bonn, Dept Neurol, Bonn, Germany [33]Caritas Hosp Saarbrucken, Dept Neurol, Saarbrucken, Germany [34]Natl & Kapodistrian Univ Athens, Sch Med, Dept Neurol 2, Athens, Greece [35]Toronto Gen Hosp, Dept Neuromuscular Med, Toronto, ON, Canada [36]Capital Med Univ, Xuanwu Hosp, Dept Neurol & Emergency, Beijing, Peoples R China [37]Royal Darwin Hosp, Dept Neurol, Tiwi, Australia [38]Antonius Ziekenhuis, Dept Neurol, Sneak, Netherlands [39]Rijnstate Hosp Arnhem, Dept Neurol, Arnhem, Netherlands [40]Royal North Shore Hosp, Dept Neurol, Sydney, NSW, Australia [41]CHU Grenoble Alpes, Dept Neurol, Grenoble, France [42]AOU Consodale Policlin Bari, Dept Neurol, Bari, Italy [43]Univ Lisbon, Ctr Hosp Univ Lisboa Norte, Hosp Santa Maria, Dept Neurosci & Mental Hlth, Lisbon, Portugal [44]Hamadan Univ Med Sci, Sina Hosp, Dept Neurol, Hamadan, Iran [45]Bufalini Hosp, Dept Neurosci, Neurol & Stroke Unit, Cesena, Italy [46]Hosp Cascais Dr Jose de Almeida, Dept Neurol, Cascais, Portugal [47]Oslo Univ Hosp, Dept Neurol, Oslo, Norway [48]UCD Sch Med, Mater Misericordiae Univ Hosp, Acute Stroke Serv, Dublin, Ireland [49]RCSI Med Sch, Dublin, Ireland [50]Univ Bretagne Occidentale, Hop Cavale Blanche, IRU Brest Univ Hosp, Inserm 1078,Dept Neurol,Stroke Unit, Brest, France [51]Foothills Med Ctr, Dept Clin Neurosci Radiol & Community Hlth Sci, Calgary, AB, Canada [52]Heidelberg Univ Hosp, Dept Neurol, Heidelberg, Germany [53]Univ Helsinki, Dept Neurol, Helsinki Univ Hosp, Helsinki, Finland [54]Univ Hosp Southampton NHS Fdn Trust, Dept Neurol, Southampton, Hants, England [55]Univ Med Ctr Schleswig Holstein, Dept Neurol, Campus Kiel, Kiel, Germany [56]Isfahan Univ Med Sci IUMS, Isfahan Neurosci Res Ctr INRC, Esfahan, Iran [57]Dept Internal INRC, Tehran, Iran [58]Radboud Univ Nijmegen Med Ctr, Dept Internal Med, Nijmegen, Netherlands [59]Radboud Univ Nijmegen Med Ctr, Radboud Inst Hlth Sci, Nijmegen, Netherlands [60]Univ Coll London Hosp UCLH, Biomed Res Ctr, Natl Inst Hlth Res, London, England [61]Lisbon Cent Univ Hosp Ctr, Stroke Ctr, Lisbon, Portugal [62]Univ Lisbon, Fac Med, Inst Med Mol Joao Lobo Antunes, Lisbon, Portugal
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关键词: hospitalization intracranial thrombosis mortality thrombocytopenia vaccination venous thrombosis

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Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0-2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94-194). Two patients died during follow-up (3% [95% CI, 1%-11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%-94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed). Conclusions: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up.

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出版当年[2021]版:
大类 | 1 区 医学
小类 | 1 区 临床神经病学 1 区 外周血管病
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 临床神经病学 1 区 外周血管病
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出版当年[2020]版:
Q1 CLINICAL NEUROLOGY Q1 PERIPHERAL VASCULAR DISEASE
最新[2023]版:
Q1 CLINICAL NEUROLOGY Q1 PERIPHERAL VASCULAR DISEASE

影响因子: 最新[2023版] 最新五年平均 出版当年[2020版] 出版当年五年平均 出版前一年[2019版] 出版后一年[2021版]

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第一作者机构: [1]Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Neurol, Amsterdam, Netherlands
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通讯机构: [1]Univ Amsterdam, Amsterdam Univ Med Ctr, Dept Neurol, Amsterdam, Netherlands [*1]Amsterdam UMC, Dept Neurol, Locat AMC, Meibergdreef 9, Amsterdam, Netherlands
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