Title :

Cerebral Venous Sinus Thrombosis due to Vaccine-Induced Immune Thrombotic Thrombocytopenia in Middle-Income Countries

Author(s) :

Van De Munckhof, Anita [Auteur]
Amsterdam University Medical Centers [Amsterdam UMC]
Borhani-Haghighi, Afshin [Auteur]
Shiraz University of Medical Sciences [Iran] [SUMS]
Aaron, Sanjith [Auteur]
Krzywicka, Katarzyna [Auteur]
Amsterdam University Medical Centers [Amsterdam UMC]
Sanchez Van Kammen, Mayte [Auteur]
Amsterdam University Medical Centers [Amsterdam UMC]
Cordonnier, Charlotte [Auteur]
Lille Neurosciences & Cognition (LilNCog) - U 1172
Kleinig, Timothy J [Auteur]
Royal Adelaide Hospital [Adelaide Australia]
Field, Thalia S [Auteur]

Poli, Sven [Auteur]
Universitätsklinikum Tübingen - University Hospital of Tübingen
Lemmens, Robin [Auteur]
University Hospitals Leuven [Leuven]
Scutelnic, Adrian [Auteur]
Bern University Hospital [Berne] [Inselspital]
Lindgren, Erik [Auteur]
Sahlgrenska University Hospital [Gothenburg]
Institute of Neuroscience and Physiology [Göteborg]
Duan, Jiangang [Auteur]
Xuanwu Hospital of Capital
Arslan, Yıldız [Auteur]
Van Gorp, Eric CM [Auteur]
Erasmus University Medical Center [Rotterdam] [Erasmus MC]
Hovinga, Johanna A Kremer [Auteur]
Bern University Hospital [Berne] [Inselspital]
Guenther, Albrecht [Auteur]
Jena University Hospital [Jena]
Jood, Katarina [Auteur]
Sahlgrenska University Hospital [Gothenburg]
Institute of Neuroscience and Physiology [Göteborg]
Tatlisumak, Turgut [Auteur]
Sahlgrenska University Hospital [Gothenburg]
Institute of Neuroscience and Physiology [Göteborg]
Putaala, Jukka [Auteur]
Helsinki University Hospital [Finland] [HUS]
Heldner, Mirjam R [Auteur]
Bern University Hospital [Berne] [Inselspital]
Arnold, Marcel [Auteur]
Bern University Hospital [Berne] [Inselspital]
Aguiar De Sousa, Diana [Auteur]
Universidade de Lisboa = University of Lisbon = Université de Lisbonne [ULISBOA]
Wasay, Mohammad [Auteur]
The Aga Khan University
Arauz-Góngora, Antonio [Auteur]
Conforto, Adriana Bastos [Auteur]
Ferro, José M [Auteur]
Universidade de Lisboa = University of Lisbon = Université de Lisbonne [ULISBOA]
Coutinho, Jonathan M [Auteur]
Amsterdam University Medical Centers [Amsterdam UMC]

Journal title :

International Journal of Stroke

Volume number :

18

Pages :

1112 - 1120

Publisher :

Wiley

Publication date :

2023-06-05

ISSN :

1747-4949

English keyword(s) :

CVST
VITT
COVID-19
vaccination
global health
thrombosis

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

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 ...
Show more >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.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Lille Neurosciences & Cognition (LilNCog) - U 1172

Research team(s) :

Troubles cognitifs dégénératifs et vasculaires

Submission date :

2024-01-15T22:53:48Z
2024-11-22T15:13:53Z