Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19-Reference-Cited by-同舟云学术

Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

Published:2023-07-11 Issue:4 Volume:8 Page:1001-1010
ISSN:2396-9873
Container-title:European Stroke Journal
language:en
Short-container-title:European Stroke Journal

Author:

Scutelnic Adrian¹^ORCID,van de Munckhof Anita²,Krzywicka Katarzyna²,van Kammen Mayte Sánchez²,Lindgren Erik³⁴,Cordonnier Charlotte⁵,Kleinig Timothy J⁶^ORCID,Field Thalia S⁷,Poli Sven⁸,Lemmens Robin⁹,Middeldorp Saskia¹⁰,Aaron Sanjith¹¹,Borhani-Haghighi Afshin¹²,Arauz Antonio¹³,Kremer Hovinga Johanna A¹⁴,Günther Albrecht¹⁵,Putaala Jukka¹⁶,Wasay Mohammad¹⁷,Conforto Adriana Bastos¹⁸,de Sousa Diana Aguiar¹⁹^ORCID,Jood Katarina³⁴,Tatlisumak Turgut³⁴,Ferro José M²⁰,Coutinho Jonathan M²,Arnold Marcel¹,Heldner Mirjam R¹,Antonenko Kateryna¹,Mbroh Joshua⁸,Brodard Justine¹⁴,Hooshmandi Etrat¹²,Dizonno Vanessa²¹,Devroye Annemie⁹,Ciccone Alfonso²²,Wittstock Matthias²³,Zimmermann Julian²³,Bode Felix J.²⁴,Skjelland Mona²⁵,Duan Jiangang²⁶,Hiltunen Sini²⁷,Zuurbier Susanna M.²,Petruzzellis Marco²⁸,Sharma Aarti R.²⁹,Ghoreishi Abdoreza³⁰,Elkady Ahmed³¹,Negro Alberto³²,Gutschalk Alexander³³,Schoenenberger Silvia³³,Nagel Simon³³,Buture Alina³⁴,Cervera Alvaro³⁵,Paiva Nunes Ana³⁶,Romina Montané Baños Ana³⁷,Tiede Andreas³⁸,Puthuppallil Anemon³⁹,Tuladhar Anil M.⁴⁰,Mengel Annerose⁸,Medina Antonio⁴¹,Hellström Vogel Åslög⁴²,Tawa Audrey⁴³,Aujayeb Avinash⁴⁴,Ramasamy Balakrishnan⁴⁵,Casolla Barbara⁴⁶,Lim Alvin Chew Beng⁴⁷,Ziaadini Bentalhoda⁴⁸,Varkey Maramattom Boby⁴⁹,Buck Brian⁵⁰,Zanferrari Carla⁵¹,Garcia-Esperon Carlos⁵²,Vayne Caroline⁵³,Legault Catherine⁵⁴,Jacobi Christian⁵⁵,Pfrepper Christian⁵⁶,Pelz Johann⁵⁶,Wahl Christoph⁵⁷,Kern Rolf⁵⁷,Tracol Clement⁵⁸,Soriano Cristina⁵⁹,Guisado-Alonso Daniel⁶⁰,Bougon David⁶¹,Bal Deepti⁶²,Sergio Zimatore Domenico⁶³,Michalski Dominik⁵⁶,Blacquiere Dylan⁶²,Johansson Elias⁶⁴⁶⁵,Cuadrado-Godia Elisa⁶⁶,Sadeghi-Hokmabadi Elyar⁶⁷,Carrera Emmanuel⁶⁸,De Maistre Emmanuel⁶⁹,Saxhaug Kristoffersen Espen⁷⁰,Bonneville Fabrice⁷¹,Geeraerts Thomas⁷¹,Vuillier Fabrice⁷²,Giammello Fabrizio⁷³,D’Onofrio Florindo⁷⁴,Grillo Francesco⁷⁵,Caparros François⁷⁶,Susen Sophie⁷⁶,Maier Frank⁷⁷,Tsivgoulis Georgios⁷⁸,Gulli Giosue⁷⁹,Frisullo Giovanni⁸⁰,Franchineau Guillaume⁸¹,Cangür Hakan⁸²,Katzberg Hans⁸³,Mozhdehipanah Hossein⁸⁴,Sibon Igor⁸⁵,Baharoglu M. Irem⁸⁶,Masjuan Jaime⁸⁷,Brar Jaskiran⁸⁸,Payen Jean-Francois⁸⁹,Burrow Jim⁹⁰,Fernandes João⁹¹,Octavio López Esparza Jorge⁹²,Oen Joyce⁹³,Schouten Judith⁹⁴,Ng Karl⁹⁵,Chatterton Sophie⁹⁵,Wronski Miriam⁹⁵,Althaus Katharina⁹⁶,Garambois Katia⁹⁷,Derex Laurent⁹⁸,Puy Laurent⁷⁶,Poorsaadat Leila⁹⁹,Valler Lenise¹⁰⁰,Januzi de Almeida Rocha Letícia¹⁰¹,Humbertjean Lisa¹⁰²,Lebrato Hernandez Lucia¹⁰³,Murillo-Bonilla Luis¹⁰⁴,Kellermair Lukas¹⁰⁵,Morin Martin Mar¹⁰⁶,Sofia Cotelli Maria¹⁰⁷,Hernandez Perez Maria¹⁰⁸,Zedde Marialuisa¹⁰⁹,Carvalho Dias Mariana¹¹⁰,Dubois Marie-Cecile¹¹¹,Carvalho Marta¹¹²,Ghiasian Masoud¹¹³,Umaiorubahan Meenakshisundaram¹¹⁴,Kumar Karunakaran Ravi¹¹⁴,Roozbeh Mehrdad¹¹⁵,Romoli Michele¹¹⁶,Miranda Miguel¹¹⁷,Saadatnia Mohammad¹¹⁸,Bandettini di Poggio Monica¹¹⁹,Scholz Moritz J.¹²⁰,Kahnis Robert¹²⁰,Almasi-Dooghaee Mostafa¹²¹,Hoseininejad Mir Nahid¹²²,Ichaporia Nasli R.¹²³,Kumar Paramasivan Naveen¹²⁴,Erat Sreedharan Sapna¹²⁴,Sylaja PN¹²⁴,Raposo Nicolas¹²⁵,Fadakar Nima¹²,Kruyt Nyika¹²⁶,Detante Olivier¹²⁷,Cuisenier Pauline¹²⁷,Huet Olivier¹²⁸,Sharma Pankaj¹²⁹,Candelaresi Paolo¹³⁰,Scoppettuolo Pasquale¹³¹,Reiner Peggy¹³²,Nemati Reza¹³³,Vieira Ricardo¹³⁴,Goh Rudy⁶,Murphy Seán³⁴,Timsit Serge¹³⁵,Coutts Shelagh¹³⁶,Sharma Shyam S.¹³⁷,Bal Simerpreet¹³⁷,Kaul Subhash¹³⁸,Karapanayiotides Theodoros¹³⁹,Cox Thomas¹⁴⁰,Gattringer Thomas¹⁴¹,Mathew Thomas¹⁴²,Bartsch Thorsten¹⁴³,Shaygannejad Vahid¹⁴⁴,Garcia-Talavera Veronica¹⁴⁵,Palma Vincenzo¹⁴⁶,Arslan Yıldız¹⁴⁷,Mirzaasgari Zahra¹⁴⁸,Yavari Zeinab¹⁴⁹,Zamani Zohreh¹⁵⁰,Bakchoul Tamam¹⁵¹,Levi Marcel¹⁵²,van Gorp Eric C.M.¹⁵³

Affiliation:

1. Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

2. Department of Neurology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, The Netherlands

3. Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden

4. Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden

5. Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France

6. Department of Neurology, Royal Adelaide Hospital, Adelaide, Australia

7. Devision of Neurology, Vancouver Stroke Program, University of British Columbia, Vancouver, Canada

8. Department of Neurology & Stroke, University Hospital Tuebingen, Eberhard-Karls University, Tuebingen, Germany

9. Department of Neurology, University Hospitals Leuven, Leuven, Belgium

10. Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands

11. Department of Neurosciences, Christian Medical College Hospital, Vellore, Tamil Nadu, India

12. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

13. Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suárez, Mexico City

14. Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland

15. Department of Neurology, Jena University Hospital, Jena, Germany

16. Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland

17. Aga Khan University, Karachi, Pakistan

18. Neurology Clinical Division, Hospital das Clínicas/São Paulo University, São Paulo, Brazil

19. Lisbon Central University Hospital and Faculdade de Medicina da Universidade de Lisboa, Portugal

20. Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Portugal

21. University of British Columbia, Vancouver, Canada

22. Department of Neurology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale di Mantova, Mantua, Italy

23. University Medicine Rostock, Rostock, Germany

24. Universitätsklinikum Bonn, Bonn, Germany

25. Oslo University Hospital, Oslo, Norway

26. Department of Neurology and Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China

27. Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

28. AOU Consorziale Policlinico di Bari, Bari, Italy

29. Imperial College School of Medicine, London, United Kingdom

30. Stroke Research Group, Head of Stroke Care Unit, Department of Neurology, Vali-e-Asr Hospital, School of Medicine, Zanjan University of Medical Sciences, Iran

31. Saudi German Hospital, Jeddah, Saudi Arabia

32. Ospedale del Mare, Naples, Italy

33. Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany;

34. Mater Misericordiae University Hospital, Dublin, Ireland

35. Royal Darwin Hospital, Tiwi, Australia

36. Lisbon Central University Hospital and Faculdade de Medicina da Universidade de Lisboa

37. Queretaro General Hospital, Santiago de Querétaro, Mexico

38. Hannover Medical School, Hannover, Germany

39. Hamilton General Hospital, Hamilton, Canada

40. Radboud University Medical Center, Department of Neurology, Donders Center for Medical Neurosciences, Nijmegen, The Netherlands

41. Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain

42. Skåne University Hospital, Lund, Sweden;

43. University Hospital of Rennes, Rennes, France;

44. Northumbria Healthcare NHS Foundation Trust, Cramlington, United Kingdom;

45. PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India;

46. Stroke Unit, Hôpital Pasteur 2, URRIS-UR2CA, Unité de Recherche Clinique Cote d’Azur, Cote d’Azur University, Nice, France;

47. Department of Neurology, John Hunter Hospital, Newcastle, Australia;

48. Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran;

49. Aster Medcity, Kochi, Kerala, India;

50. University of Alberta Hospital, Edmonton, Canada;

51. Neurology and Stroke Unit, ASST Melegnano e della Martesana - Milan – Italy

52. John Hunter Hospital, New Lambton Heights, Australia;

53. Tours University Hospital, Tours, France;

54. McGill University Health Centre, Montreal, Canada;

55. Department of Neurology, Krankenhaus Nordwest, Frankfurt am Main, Germany;

56. Leipzig University Hospital, Leipzig, Germany;

57. Kempten Hospital, Kempten, Germany;

58. CHU Rennes, Rennes, France;

59. Hospital General de Castellón, Castelló, Spain;

60. Hospital de La Santa Creu I Sant Pau, Barcelona, Spain;

61. Annecy Genevois Hospital, Annecy, France;

62. The Ottawa Hospital, Ottawa, Canada;

63. Policlinico di Bari, Bari, Italy;

64. Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden and Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden

65. Department of Clinical Science, Umeå University, Umeå, Sweden;

66. Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain;

67. NeuroSciences Research Center (NSRC), Imam-Reza hospital, Tabriz University of Medical Sciences, Tabriz, Iran;

68. Hôpitaux Universitaires de Genève, Geneva, Switzerland;

69. CHU Dijon, Dijon, France;

70. Department of Neurology, Akershus University Hospital, Lorenskog, Norway;

71. Toulouse University Hospital, Toulouse, France;

72. University Hospital of Besancon, Besancon, France;

73. Translational Molecular Medicine and Surgery 36th Cycle, Department of BIOMORF, Stroke Unit, Department of Clinical and Experimental Medicine, University Hospital G. Martino, Messina, Italy;

74. San Giuseppe Moscati Hospital, Avellino, Italy;

75. University Hospital G. Martino, Messina, Italy;

76. Université Lille, INSERM, Centre Hospitalier Universitaire (CHU) Lille, U1172–Lille Neuroscience and Cognition, Lille, France

77. Caritas Hospital Saarbrücken, Saarbrücken, Germany;

78. Second Department of Neurology, National & Kapodistrian University of Athens, School of Medicine, Athens, Greece;

79. Ashford and St Peters Hospital NHS Foundation Trust, Surrey, United Kingdom;

80. Department of Neurology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy;

81. Centre Hospitalier Intercommunal de Poissy Saint Germain en Laye, Poissy, France;

82. Hospital of the city of Wolfsburg, Wolfsburg, Germany;

83. Toronto General Hospital, Toronto, Canada;

84. Department of Neurology, Bouali University Hospital, Qazvin, Iran;

85. Bordeaux University Hospital, Bordeaux, France;

86. Haaglanden Medisch Centrum, The Hague, Netherlands;

87. Ramón y Cajal Hospital, Madrid, Spain;

88. Surrey Memorial Hospital, Surrey, Canada;

89. CHU Grenoble, Grenoble, France;

90. Royal Darwin Hospital, Tiwi, Australia;

91. Norra Älvsborgs Länssjukhus, Trollhättan, Sweden;

92. Centenario Hospital Miguel Hidalgo, Aguascalientes, México;

93. Department of Neurology, Antonius Ziekenhuis, Sneek, The Netherlands;

94. Rijnstate Hospital Arnhem, Arnhem, The Netherlands;

95. Department of Neurology, Royal North Shore Hospital, Sydney, Australia;

96. Ulm University Hospital, Ulm, Germany;

97. University Hospital of Grenoble, Grenoble, France;

98. Hospices Civils de Lyon, Lyon, France;

99. Department of Neurology, Arak University of Medical Sciences, Arak, Iran;

100. UNICAMP Universidade Estadual de Campinas, Campinas, Brazil;

101. Hospital Universitário Professor Alberto Antunes, Universidade Federal de Alagoas (HUPAA/UFAL/EBSERH), Maceió, Brazil

102. University Hospital of Nancy, Nancy, France;

103. Virgen del Rocio University Hospital, Seville, Spain;

104. Instituto Panvascular de Occidente, Guadalajara, Jalisco, México;

105. Johannes Kepler University Linz, Linz, Austria;

106. Hospital complex of Toledo, Toledo, Spain;

107. Neurology Unit ASST Valcamonica, Esine, Brescia-Italy;

108. Stroke Unit, Department of Neurosciences, Germans Trias i Pujol University Hospital, Badalona, Spain;

109. Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy;

110. Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitario Lisboa Norte, University of Lisbon, Lisbon, Portugal;

111. University Hospital of Poitiers, Poitiers, France;

112. Department of Neurology, Centro Hospitalar Universitario São João and Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Portugal;

113. Sina Hospital, Hamadan University of Medical Sciences, Hamadan, Iran;

114. Institute of Neurosciences, SIMS hospital, Chennai, Tamil Nadu, India;

115. Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran;

116. Neurology and Stroke Unit, Department of Neuroscience, Bufalini Hospital, Cesena, Italy;

117. Hospital de Cascais Dr. José de Almeida, Cascais, Portugal;

118. Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran;

119. IRCSS Ospedale Policlinico San Martino, Genoa, Italy;

120. Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany;

121. Firoozgar hospital, School of Medicine, Iran University of Medical sciences, Tehran, Iran;

122. Department of Neurology, Lorestan University of Medical Sciences, Khorramabad, Iran;

123. Sahyadri Superpeciality Hospital, Pune, Maharashtra, India;

124. Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India;

125. Department of Neurology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France;

126. Leiden University Medical Centre, Leiden, The Netherlands;

127. Department of Neurology, CHU Grenoble Alpes, Grenoble, France;

128. Hospital de la Cavale Blanche, CHRU de Brest, Brest, France;

129. Institute of Cardiovascular Disease, Royal Holloway University of London, London, United Kingdom;

130. Neurology and Stroke Unit, Cardarelli Hospital, Naples, Italy;

131. Department of Neurology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Hippocrate 10, 1200, Brussels, Belgium;

132. Lariboisière Hospital, Neurology Department, Assistance Publique Hopitaux de Paris, France;

133. Department of Neurology, Bushehr University of medical science, Bushehr, Iran;

134. Universidade Federal do Cariri, Juazeiro do Norte, Brazil;

135. Department of Neurology & stroke unit, Hôpital de la Cavale Blanche, CHRU de Brest (University Hospital), Université de Bretagne Occidentale, Inserm1078, Brest, France;

136. Foothills Medical Centre, Calgary, Canada;

137. Edinburgh Medical School, University of Edinburgh, Edinburgh, Scotland

138. KIMS Hospital, Hyderabad, Telangana, India;

139. 2nd Department of Neurology, Aristotle University of Thessaloniki, School of Medicine, AHEPA University Hospital, Greece;

140. University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom;

141. Department of Neurology and Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria;

142. St John’s Medical College Hospital, Bengaluru, Karnataka, India;

143. Dept. of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany;

144. Isfahan University of Medical Sciences (IUMS) and Isfahan Neurosciences Research Center (INRC), Isfahan, Iran;

145. Unidad medica de alta especialidad No. 25. Monterrey Nuevo León, Mexico;

146. Department of Neurology, Stroke Unit, Ospedale del Mare, ASL Napoli 1 Centro, Napoli, Italy;

147. Medicana İzmir International Hospital, Izmir, Turkey;

148. Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran;

149. Neurology, public Imam Hossein Hospital, Kermanshah, Iran;

150. Department of Neurology, Firoozabadi Hospital, Iran University of Medical Sciences, Tehran, Iran;

151. Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, Tuebingen, Germany;

152. Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands;

153. Department of Viroscience, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands

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.

Funder

The Netherlands Organisation for Health Research and Development

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine,Neurology (clinical)

Link

http://journals.sagepub.com/doi/pdf/10.1177/23969873231185213

Reference19 articles.

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5. Outcomes of patients with thromboembolic events following coronavirus disease 2019 AstraZeneca vaccination: a systematic review and meta-analysis

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