Abstract TP180: Characteristics and Outcomes of Cerebral Venous Sinus Thrombosis Associated With COVID-19

Abstract

Background: Coronavirus disease 2019 (COVID-19) increases the risk of cerebral venous sinus thrombosis (CVST), and previous reports derived from small case series reported a high mortality in these patients, up to 40%. We assessed the clinical characteristics and outcomes in an international cohort of patients with COVID-CVST. Methods: This was a registry study of consecutive COVID-CVST patients diagnosed between March 2020 and March 2023. As a comparison, we used data of patients with CVST unrelated to COVID-19,diagnosed between 2017 and 2018 and derived from the International Cerebral Venous Thrombosis Consortium database. Results: We included 70 patients with COVID-CVST from 23 hospitals in 15 countries and 206controls from 14 hospitals in 13 countries. Median age did not differ between the groups (43 vs 44years, P =0.6) but there were fewer women in the COVID-CVST group (50% vs 68%, P <0.01). The COVID severity was asymptomatic, mild or moderate in 60/69 (87%). The median thrombus load was higher in COVID-CVST patients (3 [IQR 2-4] vs 2 [1-3], P <0.01), as was the frequency of non-hemorrhagic brain lesions (47% vs 33%, P =0.03). The length of hospital stay in COVID-CVST patients was longer compared to controls (11 days [IQR 7-20] vs 8 [4-15], P =0.02). In-hospital mortality did not differ (5/67 [7%] vs 7/206 [3%], aORsex,age 2.5 [95%CI 0.7-9]), nor did the frequency of favorable clinical outcome (modified Rankin Scale 0-2, 45/56 [80%] vs 161/185 [87%], aORsex,age0.6 [0.2-1.7]) after 6 months. Conclusion: Contrary to previous reports, there was no significant difference in in-hospital mortality and long-term outcome in patients with COVID-CVST compared to patients with CVST unrelated toCOVID-19.