Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19
Date
2023
Authors
Scutelnic, A.
van de Munckhof, A.
Krzywicka, K.
van Kammen, M.S.
Lindgren, E.
Cordonnier, C.
Kleinig, T.J.
Field, T.S.
Poli, S.
Lemmens, R.
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Journal article
Citation
European Stroke Journal, 2023; 8(4):1001-1010
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Cerebral Venous Sinus Thrombosis with Thrombocytopenia Syndrome Study Group ... Adrian Scutelnic ... Timothy J Kleinig ... et al.
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Abstract
INTRODUCTION: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men. PATIENTS AND METHODS: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men. RESULTS: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28-54) vs 45 (28-56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28-79) vs 68 (30-125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19-62) vs 53 (20-92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ. DISCUSSION AND CONCLUSIONS: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.
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© European Stroke Organisation 2023 Article reuse guidelines: sagepub.com/journals-permissions