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Cerebral venous sin...
Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries
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van de Munckhof, A. (author)
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Borhani-Haghighi, A. (author)
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Aaron, S. (author)
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Krzywicka, K. (author)
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van Kammen, M. S. (author)
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Cordonnier, C. (author)
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Kleinig, T. J. (author)
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Field, T. S. (author)
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Poli, S. (author)
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Lemmens, R. (author)
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Scutelnic, A. (author)
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- Lindgren, Erik, 1993 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
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Duan, J. A. (author)
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Arslan, Y. (author)
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van Gorp, E. C. M. (author)
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Hovinga, J. A. K. (author)
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Gunther, A. (author)
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- Jood, Katarina, 1966 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
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- Tatlisumak, Turgut (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
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Putaala, J. (author)
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Heldner, M. R. (author)
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Arnold, M. (author)
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de Sousa, D. A. (author)
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Wasay, M. (author)
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Arauz, A. (author)
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Conforto, A. B. (author)
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Ferro, J. M. (author)
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Coutinho, J. M. (author)
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Johansson, Elias, 1984 (author)
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(creator_code:org_t)
- 2023
- 2023
- English.
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In: International Journal of Stroke. - 1747-4930. ; 18:9, s. 1112-1120
- Related links:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs. Aims: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs. Methods: We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs). Results: Until August 2022, 228 CVST cases were reported, of which 63 were from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these 63, 32 (51%) met the VITT criteria, compared to 103 of 165 (62%) from HICs. Only 5 of the 32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-platelet factor 4 antibodies were often not tested. The median age was 26 (interquartile range [IQR] 20-37) versus 47 (IQR 32-58) years, and the proportion of women was 25 of 32 (78%) versus 77 of 103 (75%) in MICs versus HICs, respectively. Patients from MICs were diagnosed later than patients from HICs (1/32 [3%] vs. 65/103 [63%] diagnosed before May 2021). Clinical manifestations, including intracranial hemorrhage, were largely similar as was intravenous immunoglobulin use. In-hospital mortality was lower in MICs (7/31 [23%, 95% confidence interval (CI) 11-40]) than in HICs (44/102 [43%, 95% CI 34-53], p = 0.039). Conclusions: The number of CVST-VITT cases reported from LMICs was small despite the widespread use of adenoviral vaccines. Clinical manifestations and treatment of CVST-VITT cases were largely similar in MICs and HICs, while mortality was lower in patients from MICs.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- CVST
- VITT
- COVID-19
- vaccination
- global health
- thrombosis
Publication and Content Type
- ref (subject category)
- art (subject category)
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van de Munckhof, ...
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Borhani-Haghighi ...
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Aaron, S.
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Krzywicka, K.
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van Kammen, M. S ...
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Cordonnier, C.
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show more...
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Kleinig, T. J.
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Field, T. S.
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Poli, S.
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Lemmens, R.
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Scutelnic, A.
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Lindgren, Erik, ...
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Duan, J. A.
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Arslan, Y.
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van Gorp, E. C. ...
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Hovinga, J. A. K ...
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Gunther, A.
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Jood, Katarina, ...
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Tatlisumak, Turg ...
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Putaala, J.
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Heldner, M. R.
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Arnold, M.
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de Sousa, D. A.
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Wasay, M.
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Arauz, A.
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Conforto, A. B.
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Ferro, J. M.
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Coutinho, J. M.
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Johansson, Elias ...
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show less...
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University of Gothenburg