COVID and Vaccine-related Cerebral Venous Thrombosis

Shafaq Saleem, S. Hameed, Mohammad Wasay
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Abstract

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.
COVID 和疫苗相关脑静脉血栓形成
冠状病毒病-2019(COVID-19)大流行对全球健康构成了重大威胁。它主要影响呼吸系统,但包括神经系统在内的多个器官都可能受到影响。有报告称,COVID-19 患者和 COVID 疫苗接种者中出现了脑静脉血栓 (CVT)。由于临床表现千变万化,CVT 通常仍是诊断难题。我们对 Medline(PubMed)数据库中 2020 年 1 月至 2023 年 4 月期间发表的文献进行了全面的叙述性综述。我们共搜索到 66 项研究,其中 30 项与 COVID-CVT 相关,36 项与 COVID 疫苗-CVT 相关。我们进一步研究了这些 COVID-CVT 和 COVID 疫苗相关-CVT 之间的差异,以及它们可能的病理生理学、治疗方案和预后。我们在搜索过程中重点发现了以下几点:COVID 会增加 CVT 风险,但可能没有呼吸系统表现。与传统的非 COVID-CVT 相比,COVID-CVT 更常见于中年男性,发病率更高。COVID疫苗也会增加CVT的风险,但低于COVID感染。COVID 疫苗-CVT 又分为血小板正常或低的两组。后一组报告较多,住院死亡率和出院时的残疾率较高,但这些患者在随访期间通常恢复良好。非肝素抗凝、免疫调节和手术是主要的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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