Cerebral Venous Sinus Thrombosis Following COVID-19 Vaccination: A Systematic Review

• Main Authors: Agarwala, P. (Author), Dagar, M. (Author), Dijamco, P. (Author), Ishak, A. (Author), Jaiswal, A. (Author), Jaiswal, V. (Author), Lnu, K. (Author), Mitra, S. (Author), Naz, S. (Author), Nepal, G. (Author), Sarfraz, A. (Author), Sarfraz, Z. (Author), Shama, N. (Author), Song, D. (Author)
• Format: Article
• Language: English
• Published: SAGE Publications Inc. 2022
• Subjects: adverse event; cerebral sinus thrombosis; cerebral venous sinus thrombosis; ChAdOx1 nCoV-19; COVID-19; COVID-19 vaccine; COVID-19 Vaccines; CVST; human; Humans; meta analysis; SARS-CoV-2; Sinus Thrombosis, Intracranial; vaccination; Vaccination; vaccine
• Online Access: View Fulltext in Publisher

 Introduction: COVID-19 vaccines became available after being carefully monitored in clinical trials with safety and efficacy on the human body. However, a few recipients developed unusual side effects, including cerebral venous sinus thrombosis (CVST). We aim to systematically review the baseline features, clinical characteristics, treatment, and outcomes in patients developing CVST post-COVID-19 vaccination. Methods: This study was conducted according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) 2020 guideline. Investigators independently searched PubMed, Embase, and Google Scholar for English language articles published from inception up until September 10, 2021, reporting the incidence of CVST post-COVID-19 vaccines. We analyzed CVST patients’ baseline data, type of vaccines, clinical findings, treatment, and outcomes. Our systematic review process yielded patient-level data. Result: The final analysis included 25 studies that identified 80 patients who developed CVST after the COVID-19 vaccination. Of the 80 CVST cases, 31 (39.24%) patients died. There was no significant relationship between mortality and age (P =.733), sex (P =.095), vaccine type (P =.798), platelet count (P =.93), and comorbidities such as hypertension (P =.734) and diabetes mellitus (P =.758). However, mortality was associated with the duration of onset of CVST symptoms after vaccination (P =.022). Patients with CVST post-COVID-19 vaccination were more likely to survive if treated with an anticoagulant (P =.039). Patients who developed intracranial hemorrhage (P =.012) or thrombosis in the cortical vein (P =.021) were more likely to die. Conclusion: COVID-19 vaccine-associated CVST is associated with high mortality rate. Timely diagnosis and management can be lifesaving for patients. © The Author(s) 2022.