机构：[1]Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands[2]Shiraz University of Medical Sciences, Shiraz, Iran[3]Christian Medical College Hospital, Vellore, India[4]Univ. Lille, Inserm, CHU Lille, U1172—LilNCog—Lille Neuroscience & Cognition, Lille, France[5]Royal Adelaide Hospital, Adelaide, SA, Australia[6]University of British Columbia, Vancouver, BC, Canada[7]University Hospital Tuebingen, Eberhard-Karls University, Tuebingen, Germany[8]University Hospitals Leuven, Leuven, Belgium[9]Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland[10]Sahlgrenska University Hospital, Gothenburg, Sweden[11]Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden[12]Xuanwu Hospital, Capital Medical University, Beijing, China首都医科大学宣武医院[13]Medicana İzmir International Hospital, Izmir, Turkey[14]Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands[15]Jena University Hospital, Jena, Germany[16]Helsinki University Hospital and University of Helsinki, Helsinki, Finland[17]Lisbon Central University Hospital Centre, Lisbon, Portugal[18]Aga Khan University, Karachi, Pakistan[19]National Institute of Neurology and Neurosurgery, Mexico City, Mexico[20]Hospital das Clínicas/São Paulo University, São Paulo, SP, Brazil[21]Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs.We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs.We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs).Until August 2022, 228 CVST cases were reported, of which 63 from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these, 32/63 (51%) met the VITT criteria, compared to 103/165 (62%) from HICs. Only 5/32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-PF4 antibodies were often not tested. Median age was 26 (IQR 20-37) vs 47 (IQR 32-58) years, and proportion of women was 25/32 (78%) vs 77/103 (75%) in MICs vs HICs, respectively. Patients from MICs were diagnosed later than patients from HICs (1/32 [3%] vs 65/103 [63%] diagnosed before May 2021). Clinical manifestations, including intracranial hemorrhage, were largely similar as was intravenous immunoglobulin use. In-hospital mortality was lower in MICs (7/31 [23%, 95%CI 11-40]) than HICs (44/102 [43%, 95%CI 34-53], p=0.039).The number of CVST-VITT cases reported from LMICs was small despite widespread use of adenoviral vaccines. Clinical manifestations and treatment of CVST-VITT cases were largely similar in MICs and HICs, while mortality was lower in patients from MICs.
基金：
The author(s) disclosed receipt of the following financial support
for the research, authorship, and/or publication of this article:Netherlands Organization for Health Research and Development
(ZonMw, grant 10430072110005), Dr CJ Vaillant Foundation,
Hospital District of Helsinki and Uusimaa (grant TYH2022223).
第一作者机构：[1]Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands
通讯作者：
通讯机构：[1]Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands[*1]Amsterdam University Medical Centers, location University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
推荐引用方式(GB/T 7714)：
Anita van de Munckhof,Afshin Borhani-Haghighi,Sanjith Aaron,et al.Cerebral Venous Sinus Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia in Middle-Income Countries[J].INTERNATIONAL JOURNAL OF STROKE.2023,18(9):1112-1120.doi:10.1177/17474930231182901.
APA：
Anita van de Munckhof,Afshin Borhani-Haghighi,Sanjith Aaron,Katarzyna Krzywicka,Mayte Sánchez van Kammen...&Jonathan M Coutinho.(2023).Cerebral Venous Sinus Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia in Middle-Income Countries.INTERNATIONAL JOURNAL OF STROKE,18,(9)
MLA：
Anita van de Munckhof,et al."Cerebral Venous Sinus Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia in Middle-Income Countries".INTERNATIONAL JOURNAL OF STROKE 18..9(2023):1112-1120
