Background and Purpose: Coronavirus disease 2019 (CO­VID-19) has an increased propensity for systemic hypercoagulability and thromboembolism. An association with cerebrovascular diseases, especially cerebral venous thrombosis (CVT), has been reported among these patients. The objective of the present study was to identify risk factors for CVT as well as its presentation and outcome in COVID-19 patients. Methods: This is a multicenter and multinational observational study. Ten centers in 4 countries (Pakistan, Egypt, Singapore, and the United Arab Emirates) participated in this study. The study included patients (aged #x3e;18 years) with symptomatic CVT and recent COVID-19 infection. Results: Twenty patients (70% men) were included. Their mean age was 42.4 years, with a male-to-female ratio of 2.3:1. Headache (85%) and seizures (65%) were the common presenting symptoms, with a mean admission Glasgow Coma Scale (GCS) score of 13. CVT was the presenting feature in 13 cases (65%), while 7 patients (35%) developed CVT while being treated for COVID-19 infection. Respiratory symptoms were absent in 45% of the patients. The most common imaging finding was infarction (65%), followed by hemorrhage (20%). The superior sagittal sinus (65%) was the most common site of thrombosis. Acute inflammatory markers were raised, including elevated serum D-dimer (87.5%), erythrocyte sedimentation rate (69%), and C-reactive protein (47%) levels. Homocysteine was elevated in half of the tested cases. The mortality rate was 20% (4 patients). A good functional outcome was seen in the surviving patients, with a mean modified Rankin Scale score at discharge of 1.3. Nine patients (45%) had a modified Rankin Scale score of 0–1 at discharge. Conclusion: COVID-19-related CVT is more common among males at older ages when compared to previously reported non-COVID-19-related CVT cases. CVT should be suspected in COVID-19 patients presenting with headache or seizures. Mortality is high, but functional neurological outcome is good among survivors.
Cerebrovasc Dis Extra 2021;11:55–60

中文翻译：

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与 COVID-19 感染相关的脑静脉血栓形成：一项观察性多中心研究

背景和目的： 2019 年冠状病毒病 (COVID-19) 出现全身高凝状态和血栓栓塞的倾向增加。据报道，这些患者与脑血管疾病有关，尤其是脑静脉血栓形成 (CVT)。本研究的目的是确定 CVT 的危险因素及其在 COVID-19 患者中的表现和结果。方法：这是一项多中心和多国观察性研究。4 个国家（巴基斯坦、埃及、新加坡和阿拉伯联合酋长国）的 10 个中心参与了这项研究。该研究包括患有症状性 CVT 和近期 COVID-19 感染的患者（年龄 #x3e；18 岁）。结果：包括 20 名患者（70% 为男性）。他们的平均年龄为 42.4 岁，男女比例为 2.3:1。头痛 (85%) 和癫痫 (65%) 是常见的主诊症状，入院时格拉斯哥昏迷量表 (GCS) 平均评分为 13。 CVT 是 13 例 (65%) 的主诊特征，而 7 名患者 (35%) ) 在接受 COVID-19 感染治疗时发展为 CVT。45% 的患者没有呼吸系统症状。最常见的影像学发现是梗塞 (65%)，其次是出血 (20%)。上矢状窦（65%）是最常见的血栓形成部位。急性炎症标志物升高，包括升高的血清 D-二聚体 (87.5%)、红细胞沉降率 (69%) 和 C-反应蛋白 (47%) 水平。在一半的测试病例中同型半胱氨酸升高。死亡率为 20%（4 名患者）。在存活患者中观察到良好的功能结果，出院时平均改良 Rankin 量表评分为 1.3。9 名患者 (45%) 在出院时的改良 Rankin 量表评分为 0-1。结论：与先前报告的非 COVID-19 相关 CVT 病例相比，COVID-19 相关 CVT 在年龄较大的男性中更为常见。出现头痛或癫痫发作的 COVID-19 患者应怀疑 CVT。死亡率很高，但幸存者的神经功能结果良好。
Cerebrovasc Dis Extra 2021；11:55–60