Cerebral Venous Thrombosis in COVID-19: A New York Metropolitan Cohort Study

Authors

Fawaz Al-Mufti, New York Medical CollegeFollow
Ramandeep Sahni, New York Medical College
Philip Overby, New York Medical CollegeFollow
Edwin Gulko, New York Medical College
Stephan A. Mayer, New York Medical CollegeFollow
Chirag D. Gandhi, New York Medical CollegeFollow

Author Type(s)

Faculty

DOI

10.3174/ajnr.A7134

Journal Title

AJNR. American Journal of Neuroradiology

First Page

1196

Last Page

1200

Document Type

Article

Publication Date

7-2021

Department

Neurosurgery

Second Department

Neurology

Third Department

Pediatrics

Keywords

Adult, COVID-19, Causality, Cohort Studies, Comorbidity, Female, Humans, Intracranial Thrombosis, Male, Middle Aged, New York City, Retrospective Studies, Risk Factors, Thrombectomy, Thromboembolism, Venous Thrombosis

Disciplines

Medicine and Health Sciences

Abstract

BACKGROUND AND PURPOSE: Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection is associated with hypercoagulability. We sought to evaluate the demographic and clinical characteristics of cerebral venous thrombosis among patients hospitalized for coronavirus disease 2019 (COVID-19) at 6 tertiary care centers in the New York City metropolitan area.

MATERIALS AND METHODS: We conducted a retrospective multicenter cohort study of 13,500 consecutive patients with COVID-19 who were hospitalized between March 1 and May 30, 2020.

RESULTS: Of 13,500 patients with COVID-19, twelve had imaging-proved cerebral venous thrombosis with an incidence of 8.8 per 10,000 during 3 months, which is considerably higher than the reported incidence of cerebral venous thrombosis in the general population of 5 per million annually. There was a male preponderance (8 men, 4 women) and an average age of 49 years (95% CI, 36-62 years; range, 17-95 years). Only 1 patient (8%) had a history of thromboembolic disease. Neurologic symptoms secondary to cerebral venous thrombosis occurred within 24 hours of the onset of the respiratory and constitutional symptoms in 58% of cases, and 75% had venous infarction, hemorrhage, or both on brain imaging. Management consisted of anticoagulation, endovascular thrombectomy, and surgical hematoma evacuation. The mortality rate was 25%.

CONCLUSIONS: Early evidence suggests a higher-than-expected frequency of cerebral venous thrombosis among patients hospitalized for COVID-19. Cerebral venous thrombosis should be included in the differential diagnosis of neurologic syndromes associated with SARS-CoV-2 infection.

Comments

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Recommended Citation

Al-Mufti, F., Sahni, R., Overby, P., Gulko, E., Mayer, S. A., & Gandhi, C. D. (2021). Cerebral Venous Thrombosis in COVID-19: A New York Metropolitan Cohort Study. AJNR. American Journal of Neuroradiology, 42 (7), 1196-1200. https://doi.org/10.3174/ajnr.A7134