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

• Published in: Journal of primary care & community health 2022-02, Vol.13, p.21501319221074450-21501319221074450
• Main Authors: Jaiswal, Vikash, Nepal, Gaurav, Dijamco, Patricia, Ishak, Angela, Dagar, Mehak, Sarfraz, Zouina, Shama, Nishat, Sarfraz, Azza, Lnu, Kriti, Mitra, Saloni, Agarwala, Preeti, Naz, Sidra, Song, David, Jaiswal, Akash
• Format: Article
• Language: English
• Subjects: Anticoagulants; ChAdOx1 nCoV-19; Clinical research; Clinical trials; Coronaviruses; COVID-19; COVID-19 Vaccines; Diabetes; Efficacy; English language; Hemorrhage; Human body; Humans; Hypertension; Immunization; Medical diagnosis; Mortality; Mortality rates; Original Research; SARS-CoV-2; Side effects; Sinus Thrombosis, Intracranial - etiology; Systematic review; Thrombosis; Vaccination - adverse effects; Vaccines
• ISSN: 2150-1319; 2150-1327
• DOI: 10.1177/21501319221074450

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.