Please use this identifier to cite or link to this item: https://hdl.handle.net/10137/12204
Title: Management of cerebral venous thrombosis due to adenoviral COVID-19 vaccination.
Authors: Scutelnic, Adrian
Krzywicka, Katarzyna
Mbroh, Joshua
van de Munckhof, Anita
Sánchez van Kammen, Mayte
Aguiar de Sousa, Diana
Lindgren, Erik
Jood, Katarina
Günther, Albrecht
Hiltunen, Sini
Putaala, Jukka
Ferro, José M
Coutinho, Jonathan M
Arnold, Marcel
Poli, Sven
Heldner, Mirjam R
Tiede, Andreas
Maier, Frank
Kern, Rolf
Bartsch, Thorsten
Althaus, Katharina
Ciccone, Alfonso
Wiedmann, Markus
Skjelland, Mona
Medina, Antonio
Cuadrado-Godia, Elisa
Cox, Thomas
Aujayeb, Avinash
Raposo, Nicolas
Garambois, Katia
Payen, Jean-Francois
Vuillier, Fabrice
Franchineau, Guillaume
Timsit, Serge
Bougon, David
Dubois, Marie-Cécile
Tawa, Audrey
Tracol, Clement
De Maistre, Emmanuel
Bonneville, Fabrice
Vayne, Caroline
Mengel, Annerose
Michalski, Dominik
Pelz, Johann
Wittstock, Matthias
Bode, Felix
Zimmermann, Julian
Schouten, Judith
Buture, Alina
Murphy, Sean
Palma, Vincenzo
Negro, Alberto
Gutschalk, Alexander
Nagel, Simon
Schoenenberger, Silvia
Frisullo, Giovanni
Zanferrari, Carla
Grillo, Francesco
Giammello, Fabrizio
Martin, Mar Morin
Cervera, Alvaro
Burrow, Jim
Garcia Esperon, Carlos
Chew, Beng Lim Alvin
Kleinig, Timothy J
Soriano, Cristina
Zimatore, Domenico S
Petruzzellis, Marco
Elkady, Ahmed
Miranda, Miguel S
Fernandes, João
Hellström Vogel, Åslög
Johansson, Elias
Philip, Anemon Puthuppallil
Coutts, Shelagh B
Bal, Simerpreet
Buck, Brian
Legault, Catherine
Blacquiere, Dylan
Katzberg, Hans D
Field, Thalia S
Dizonno, Vanessa
Gattringer, Thomas
Jacobi, Christian
Devroye, Annemie
Lemmens, Robin
Kristoffersen, Espen Saxhaug
Bandettini di Poggio, Monica
Ghiasian, Masoud
Karapanayiotides, Theodoros
Chatterton, Sophie
Wronski, Miriam
Ng, Karl
Kahnis, Robert
Geeraerts, Thomas
Reiner, Peggy
Cordonnier, Charlotte
Middeldorp, Saskia
Levi, Marcel
van Gorp, Eric C M
van de Beek, Diederik
Brodard, Justine
Kremer Hovinga, Johanna A
Kruip, Marieke J H A
Tatlisumak, Turgut
Citation: This article is protected by copyright. All rights reserved.
Ann Neurol. 2022 Jun 10. doi: 10.1002/ana.26431.
Abstract: OBJECTIVE: Cerebral venous thrombosis caused by vaccine-induced immune thrombotic thrombocytopenia (VITT-CVT) is a rare adverse effect of adenovirus-based SARS-CoV-2 vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. METHODS: We used data from an international prospective registry of patients with CVT after adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable or definite VITT-CVT cases included until 18 January 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. RESULTS: 99 VITT-CVT patients from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11/24 (46%), and 28/37 (76%) of patients diagnosed in March, April, and from May onwards, respectively, were treated in-line with VITT recommendations (p<0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 (32%) vs 29/55 (52%), adjusted OR 0.43 (95%CI 0.16-1.19)). However, patients who received immunomodulation had lower mortality (19/65 (29%) vs 24/34 (70%), adjusted OR 0.19 (95%CI 0.06-0.58)). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 (33%) vs 13/35 (37%), adjusted OR 0.70 (95%CI 0.24-2.04)). Mortality was also not significantly influenced by platelet transfusion (17/27 (63%) vs 26/72 (36%), adjusted OR 2.19 (95%CI 0.74-6.54)). CONCLUSIONS: In VITT-CVT patients, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT. This article is protected by copyright. All rights reserved.
Click to open Pubmed Article: https://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/35689346
Journal title: Annals of neurology
Publication Date: 2022-06-10
Type: Journal Article
URI: https://hdl.handle.net/10137/12204
DOI: 10.1002/ana.26431
Orcid: 0000-0001-9053-584X
0000-0002-0108-9161
0000-0001-5614-9689
0000-0002-7628-5044
0000-0002-6630-6104
0000-0002-9152-4445
0000-0003-0346-8576
0000-0002-5178-7793
0000-0002-3348-6719
0000-0002-2828-1305
0000-0001-8843-5890
0000-0002-6065-6576
0000-0002-8999-5424
0000-0002-5697-6892
0000-0002-3594-2159
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