학술논문
Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase
Document Type
Author
Van De Munckhof, Anita; Lindgren, Erik; Kleinig, Timothy J.; Field, Thalia S.; Cordonnier, Charlotte; Krzywicka, Katarzyna; Poli, Sven; Sánchez Van Kammen, Mayte; Borhani-Haghighi, Afshin; Lemmens, Robin; Scutelnic, Adrian; Ciccone, Alfonso; Gattringer, Thomas; Wittstock, Matthias; Dizonno, Vanessa; Devroye, Annemie; Elkady, Ahmed; Günther, Albrecht; Cervera, Alvaro; Mengel, Annerose; Chew, Beng Lim Alvin; Buck, Brian; Zanferrari, Carla; Garcia-Esperon, Carlos; Jacobi, Christian; Soriano, Cristina; Michalski, Dominik; Zamani, Zohreh; Blacquiere, Dylan; Johansson, Elias; Cuadrado-Godia, Elisa; Vuillier, Fabrice; Bode, Felix J.; Caparros, François; Maier, Frank; Tsivgoulis, Georgios; Katzberg, Hans D.; Duan, Jiangang; Burrow, Jim; Pelz, Johann; Mbroh, Joshua; Oen, Joyce; Schouten, Judith; Zimmermann, Julian; Ng, Karl; Garambois, Katia; Petruzzellis, Marco; Carvalho Dias, Mariana; Ghiasian, Masoud; Romoli, Michele; Miranda, Miguel; Wronski, Miriam; Skjelland, Mona; Almasi-Dooghaee, Mostafa; Cuisenier, Pauline; Murphy, Seán; Timsit, Serge; Coutts, Shelagh B.; Schönenberger, Silvia; Nagel, Simon; Hiltunen, Sini; Chatterton, Sophie; Cox, Thomas; Bartsch, Thorsten; Shaygannejad, Vahid; Mirzaasgari, Zahra; Middeldorp, Saskia; Levi, Marcel M.; Kremer Hovinga, Johanna A.; Jood, Katarina; Tatlisumak, Turgut; Putaala, Jukka; Heldner, Mirjam R.; Arnold, Marcel; Aguiar De Sousa, Diana; Ferro, José M.; Coutinho, Jonathan M.
Source
Stroke. 53(10):3206-3210
Subject
Language
English
ISSN
0039-2499
1524-4628
1524-4628
Abstract
Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization.Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0-2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization).Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94-194). Two patients died during follow-up (3% [95% CI, 1%-11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%-94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed).Conclusions: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up.