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SHR Neuro Cancer Cardio Lipid Metab Microb
van, de, Munckhof, A; Borhani-Haghighi, A; Aaron, S; Krzywicka, K; van, Kammen, MS; Cordonnier, C; Kleinig, TJ; Field, TS; Poli, S; Lemmens, R; Scutelnic, A; Lindgren, E; Duan, J; Arslan, Y; van, Gorp, EC; Kremer, Hovinga, JA; Günther, A; Jood, K; Tatlisumak, T; Putaala, J; Heldner, MR; Arnold, M; de, Sousa, DA; Wasay, M; Arauz, A; Conforto, AB; Ferro, JM; Coutinho, JM; Cerebral Venous Sinus Thrombosis with Thrombocytopenia Syndrome Study Group.
Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries.
Int J Stroke. 2023; 18(9): 1112-1120.
Doi: 10.1177/17474930231182901
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- Study Group Members Med Uni Graz:
- Gattringer Thomas
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- Abstract:
- 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.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Female - administration & dosage
- Young Adult - administration & dosage
- Adult - administration & dosage
- COVID-19 Vaccines - adverse effects
- Developing Countries - administration & dosage
- Stroke - administration & dosage
- Thrombocytopenia - epidemiology, etiology
- Vaccines - administration & dosage
- Sinus Thrombosis, Intracranial - epidemiology, etiology
- Find related publications in this database (Keywords)
- CVST
- VITT
- COVID-19
- vaccination
- global health
- thrombosis