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Título

Cerebral Venous Thrombosis in Times of Pandemic SARS-CoV-2: NeuroCOVID Study Case Series

Resumo

Introduction: Cerebral venous thrombosis (CVT) is a rare cause of stroke associated with significant morbidity and mortality. COVID-19 began in 2019, when an outbreak of atypical pneumonia occurred in the city of Wuhan (China), and the etiologic agent was identified as a novel human pathogen from the family Coronaviridae, called Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2). As the pandemic progressed, cases of stroke in young patients without cardiovascular risk factors were reported and new cases of CVT associated with both the infection and vaccination were also described.
Objective: To describe the clinical, epidemiological, and laboratory characteristics of patients with cerebral venous thrombosis admitted to a public referral hospital.
Methods: This is a case series study nested within the multicenter case-control entitled NeuroCOVID: Association of SARS-CoV-2 with the occurrence, prognosis and pathogenesis of cerebrovascular diseases, funded by the Inova Fiocruz Program (Fundação Oswaldo Cruz - COVID-19 Emergency Fund: VPPCB-005 FIO-20-2-22).
Results: Over a 1-year period of data collection, 19 patients included had a clinical and radiological diagnosis of CVT. It is evident that 84.2% of the sample was composed of women and 42.1% self-declared as brown. Only 26.3% and 5.3% reported having hypertension and diabetes mellitus, respectively. Approximately 62.5% of women used contraceptives. Only 2 patients reported a diagnosis of COVID-19 in the 30 days preceding hospitalization. Headache was the most reported symptom (89.5%), followed by seizures (26.3%). Approximately 63.2% had venous infarction and 52.6% had an associated hemorrhagic event. Thirty-six percent received covid19 vaccination with pfizer; 21.1% received astrazeneca. The minimum, median, and maximum times between vaccination and the occurrence of CVT were, in days: 22, 75, and 159, respectively. Two patients (10.5%) were RT-PCR positive for COVID19 on admission; 63.2% were IgA positive for COVID19 and 73.7% were IgG positive for COVID19. The minimum, median, and maximum number of platelets were: 158.000, 221.350 and 382.500/mm3.
Conclusions: Our study highlights the clinical and laboratory characteristics of patients with CVT in pandemic COVID19. The main limitation is that this is a small case series from a single center.

Palavras Chave

Cerebral Thrombosis; Venous Thrombosis; Stroke; Pandemics; COVID-19.