Abstract WMP49: Outcomes of Patients With Cerebral Venous Thrombosiswith and Without COVID-19 Infection

Abstract

Introduction: COVID-19 infection has thus emerged to be a new risk factor for Cerebral Venous Thrombosis (CVT). Our study aimed to compare outcomes of patients diagnosed with CVT within 2 weeks of COVID infection compared to those without COVID-19. Methods: Adult patients with CVT diagnosis from 2020-2022 in TriNetX COVID research network were included in the study. Patients diagnosed with COVID within 2 weeks of CVT diagnosis were defined as CVT with COVID. CVT without COVID group included those without COVID diagnosis any time before and up to three months after diagnosis of CVT. All-cause mortality was the primary outcome. Acute ischemic stroke (AIS), intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), epilepsy, deep vein thrombosis and pulmonary embolism were secondary outcomes. 1:1 propensity score matching was performed to control for age, sex, race, ethnicity, obesity, malignancy and medications. The two groups were compared with cox proportional hazard analysis and reported as hazard ratio (HR) and 95% confidence interval (CI). Results: A total of 424 patients with CVT and COVID-19 and 8,969 patients with CVT without COVID met the study criteria. After 1:1 propensity score matching, 422 patients were included in both cohorts. The group CVT with COVID-19 infection within two weeks of diagnosis of CVT had two times higher risk of all-cause mortality at one month [31 (7.3%) vs 16 (3.8%); HR=1.94; 95% CI=1.06-3.55] and three months [43 (10.2%) vs 17 (4.0%); HR=2.57; 95% CI=1.46-4.50] compared to CVT without COVID. CVT patients with COVID were two times more likely to have complications of ICH [1 month: 11.6% vs 5.5%; HR=2.16; 95% CI=1.23-3.64 and three months: 11.6% vs 6.3%; HR=1.90; 95% CI=1.15-3.13] and SAH [1 month: 8.3% vs 4.2%; HR=2.00; 95% CI=1.11-3.59 and three months: 8.3% vs 4.5%; HR=1.89; 95% CI=1.07-3.36]. CVT with COVID patients were more likely to develop deep vein thrombosis at one month (19.8% vs 13.6%; HR=1.51; 95% CI=1.04-2.20) but not at three months. There was no difference in diagnosis of AIS, epilepsy and pulmonary embolism at one and three months in the two groups. Conclusion: CVT patients with COVID-19 infection in the prior two weeks are two times more likely to die and have complications of ICH and SAH compared to CVT without COVID-19.