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Sex Differences in Cerebral Venous Sinus Thrombosis After Adenoviral Vaccination Against Covid-19 Publisher Pubmed



Scutelnic A1 ; Van De Munckhof A2 ; Krzywicka K2 ; Van Kammen MS2 ; Lindgren E3, 4 ; Cordonnier C5 ; Kleinig TJ6 ; Field TS7 ; Poli S8 ; Lemmens R9 ; Middeldorp S10 ; Aaron S11 ; Borhanihaghighi A12 ; Arauz A13 Show All Authors
Authors
  1. Scutelnic A1
  2. Van De Munckhof A2
  3. Krzywicka K2
  4. Van Kammen MS2
  5. Lindgren E3, 4
  6. Cordonnier C5
  7. Kleinig TJ6
  8. Field TS7
  9. Poli S8
  10. Lemmens R9
  11. Middeldorp S10
  12. Aaron S11
  13. Borhanihaghighi A12
  14. Arauz A13
  15. Kremer Hovinga JA14
  16. Gunther A15
  17. Putaala J16
  18. Wasay M17
  19. Conforto AB18
  20. De Sousa DA19
  21. Jood K3, 4
  22. Tatlisumak T3, 4
  23. Ferro JM20
  24. Coutinho JM2
  25. Arnold M1
  26. Heldner MR1
  27. Antonenko K1
  28. Mbroh J8
  29. Brodard J14
  30. Hooshmandi E12
  31. Dizonno V21
  32. Devroye A9
  33. Ciccone A22
  34. Wittstock M23
  35. Zimmermann J23
  36. Bode FJ24
  37. Skjelland M25
  38. Duan J26
  39. Hiltunen S27
  40. Zuurbier SM2
  41. Petruzzellis M28
  42. Sharma AR29
  43. Ghoreishi A30
  44. Elkady A31
  45. Negro A32
  46. Gutschalk A33
  47. Schoenenberger S33
  48. Nagel S33
  49. Buture A34
  50. Cervera A35
  51. Paiva Nunes A36
  52. Romina Montane Banos A37
  53. Tiede A38
  54. Puthuppallil A39
  55. Tuladhar AM40
  56. Mengel A8
  57. Medina A41
  58. Hellstrom Vogel A42
  59. Tawa A43
  60. Aujayeb A44
  61. Ramasamy B45
  62. Casolla B46
  63. Lim Alvin Chew B47
  64. Ziaadini B48
  65. Varkey Maramattom B49
  66. Buck B50
  67. Zanferrari C51
  68. Garciaesperon C52
  69. Vayne C53
  70. Legault C54
  71. Jacobi C55
  72. Pfrepper C56
  73. Pelz J56
  74. Wahl C57
  75. Kern R57
  76. Tracol C58
  77. Soriano C59
  78. Guisadoalonso D60
  79. Bougon D61
  80. Bal D62
  81. Sergio Zimatore D63
  82. Michalski D56
  83. Blacquiere D62
  84. Johansson E3, 64, 152
  85. Cuadradogodia E65
  86. Sadeghihokmabadi E66
  87. Carrera E67
  88. De Maistre E68
  89. Saxhaug Kristoffersen E69
  90. Bonneville F70
  91. Geeraerts T70
  92. Vuillier F71
  93. Giammello F72
  94. Donofrio F73
  95. Grillo F74
  96. Caparros F75
  97. Susen S75
  98. Maier F76
  99. Tsivgoulis G77
  100. Gulli G78
  101. Frisullo G79
  102. Franchineau G80
  103. Cangur H81
  104. Katzberg H82
  105. Mozhdehipanah H83
  106. Sibon I84
  107. Baharoglu MI85
  108. Masjuan J86
  109. Brar J87
  110. Payen JF88
  111. Burrow J35
  112. Fernandes J89
  113. Octavio Lopez Esparza J90
  114. Oen J91
  115. Schouten J92
  116. Ng K93
  117. Chatterton S93
  118. Wronski M93
  119. Althaus K94
  120. Garambois K95
  121. Derex L96
  122. Puy L75
  123. Poorsaadat L97
  124. Valler L98
  125. Januzi De Almeida Rocha L99
  126. Humbertjean L100
  127. Lebrato Hernandez L101
  128. Murillobonilla L102
  129. Kellermair L103
  130. Morin Martin M104
  131. Sofia Cotelli M105
  132. Hernandez Perez M106
  133. Zedde M107
  134. Carvalho Dias M108
  135. Dubois MC109
  136. Carvalho M110
  137. Ghiasian M111
  138. Umaiorubahan M112
  139. Kumar Karunakaran R112
  140. Roozbeh M113
  141. Romoli M114
  142. Miranda M115
  143. Saadatnia M116
  144. Bandettini Di Poggio M117
  145. Scholz MJ118
  146. Kahnis R118
  147. Almasidooghaee M119
  148. Hoseininejad Mir N120
  149. Ichaporia NR121
  150. Kumar Paramasivan N122
  151. Erat Sreedharan S122
  152. Sylaja PN122
  153. Raposo N123
  154. Fadakar N12
  155. Kruyt N124
  156. Detante O125
  157. Cuisenier P125
  158. Huet O126
  159. Sharma P127
  160. Candelaresi P128
  161. Scoppettuolo P129
  162. Reiner P130
  163. Nemati R131
  164. Vieira R132
  165. Goh R6
  166. Murphy S34
  167. Timsit S133
  168. Coutts S134
  169. Sharma SS135
  170. Bal S135
  171. Kaul S136
  172. Karapanayiotides T137
  173. Cox T138
  174. Gattringer T139
  175. Mathew T140
  176. Bartsch T141
  177. Shaygannejad V142
  178. Garciatalavera V143
  179. Palma V144
  180. Arslan Y145
  181. Mirzaasgari Z146
  182. Yavari Z147
  183. Zamani Z148
  184. Bakchoul T149
  185. Levi M150
  186. Van Gorp ECM151
Show Affiliations
Authors Affiliations
  1. 1. Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
  2. 2. Department of Neurology, Amsterdam University Medical Centers, location University of Amsterdam, Amsterdam, Netherlands
  3. 3. Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
  4. 4. Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
  5. 5. Univ. Lille, Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille, France
  6. 6. Department of Neurology, Royal Adelaide Hospital, Adelaide, Australia
  7. 7. Devision of Neurology, Vancouver Stroke Program, University of British Columbia, Vancouver, Canada
  8. 8. Department of Neurology & Stroke, University Hospital Tuebingen, Eberhard-Karls University, Tuebingen, Germany
  9. 9. Department of Neurology, University Hospitals Leuven, Leuven, Belgium
  10. 10. Department of Internal Medicine, Radboud University Medical Center, Nijmegen, Netherlands
  11. 11. Department of Neurosciences, Christian Medical College Hospital, Tamil Nadu, Vellore, India
  12. 12. Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
  13. 13. Instituto Nacional de Neurologia y Neurocirugia Manuel Velasco Suarez, Mexico City, Mexico
  14. 14. Department of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
  15. 15. Department of Neurology, Jena University Hospital, Jena, Germany
  16. 16. Department of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
  17. 17. Aga Khan University, Karachi, Pakistan
  18. 18. Neurology Clinical Division, Hospital das Clinicas/Sao Paulo University, Sao Paulo, Brazil
  19. 19. Lisbon Central University Hospital and Faculdade de Medicina da Universidade de Lisboa, Portugal
  20. 20. Instituto de Medicina Molecular Joao Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, Portugal
  21. 21. University of British Columbia, Vancouver, Canada
  22. 22. Department of Neurology, Carlo Poma Hospital, Azienda Socio Sanitaria Territoriale di Mantova, Mantua, Italy
  23. 23. University Medicine Rostock, Rostock, Germany
  24. 24. Universitatsklinikum Bonn, Bonn, Germany
  25. 25. Oslo University Hospital, Oslo, Norway
  26. 26. Department of Neurology and Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China
  27. 27. Department of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
  28. 28. AOU Consorziale Policlinico di Bari, Bari, Italy
  29. 29. Imperial College School of Medicine, London, United Kingdom
  30. 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. 31. Saudi German Hospital, Jeddah, Saudi Arabia
  32. 32. Ospedale del Mare, Naples, Italy
  33. 33. Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
  34. 34. Mater Misericordiae University Hospital, Dublin, Ireland
  35. 35. Royal Darwin Hospital, Tiwi, Australia
  36. 36. Lisbon Central University Hospital, Faculdade de Medicina, Universidade de Lisboa, Portugal
  37. 37. Queretaro General Hospital, Santiago de Queretaro, Mexico
  38. 38. Hannover Medical School, Hannover, Germany
  39. 39. Hamilton General Hospital, Hamilton, Canada
  40. 40. Radboud University Medical Center, Department of Neurology, Donders Center for Medical Neurosciences, Nijmegen, Netherlands
  41. 41. Hospital Universitario Nuestra Senora de Candelaria, Santa Cruz de Tenerife, Spain
  42. 42. Skane University Hospital, Lund, Sweden
  43. 43. University Hospital of Rennes, Rennes, France
  44. 44. Northumbria Healthcare NHS Foundation Trust, Cramlington, United Kingdom
  45. 45. PSG Institute of Medical Sciences and Research, Tamil Nadu, Coimbatore, India
  46. 46. Stroke Unit, Hopital Pasteur 2, URRIS-UR2CA, Unite de Recherche Clinique Cote d’Azur, Cote d’Azur University, Nice, France
  47. 47. Department of Neurology, John Hunter Hospital, Newcastle, Australia
  48. 48. Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran
  49. 49. Aster Medcity, Kerala, Kochi, India
  50. 50. University of Alberta Hospital, Edmonton, Canada
  51. 51. Neurology and Stroke Unit, ASST Melegnano e della Martesana, Milan, Italy
  52. 52. John Hunter Hospital, New Lambton Heights, Australia
  53. 53. Tours University Hospital, Tours, France
  54. 54. McGill University Health Centre, Montreal, Canada
  55. 55. Department of Neurology, Krankenhaus Nordwest, Frankfurt am Main, Germany
  56. 56. Leipzig University Hospital, Leipzig, Germany
  57. 57. Kempten Hospital, Kempten, Germany
  58. 58. CHU Rennes, Rennes, France
  59. 59. Hospital General de Castellon, Castello, Spain
  60. 60. Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
  61. 61. Annecy Genevois Hospital, Annecy, France
  62. 62. The Ottawa Hospital, Ottawa, Canada
  63. 63. Policlinico di Bari, Bari, Italy
  64. 64. Department of Clinical Science, Umea University, Umea, Sweden
  65. 65. Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
  66. 66. NeuroSciences Research Center (NSRC), Imam-Reza hospital, Tabriz University of Medical Sciences, Tabriz, Iran
  67. 67. Hopitaux Universitaires de Geneve, Geneva, Switzerland
  68. 68. CHU Dijon, Dijon, France
  69. 69. Department of Neurology, Akershus University Hospital, Lorenskog, Norway
  70. 70. Toulouse University Hospital, Toulouse, France
  71. 71. University Hospital of Besancon, Besancon, France
  72. 72. Translational Molecular Medicine and Surgery 36th Cycle, Department of BIOMORF, Stroke Unit, Department of Clinical and Experimental Medicine, University Hospital G. Martino, Messina, Italy
  73. 73. San Giuseppe Moscati Hospital, Avellino, Italy
  74. 74. University Hospital G. Martino, Messina, Italy
  75. 75. Universite Lille, INSERM, Centre Hospitalier Universitaire (CHU) Lille, U1172–Lille Neuroscience and Cognition, Lille, France
  76. 76. Caritas Hospital Saarbrucken, Saarbrucken, Germany
  77. 77. Second Department of Neurology, National $and$ Kapodistrian University of Athens, School of Medicine, Athens, Greece
  78. 78. Ashford and St Peters Hospital NHS Foundation Trust, Surrey, United Kingdom
  79. 79. Department of Neurology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
  80. 80. Centre Hospitalier Intercommunal de Poissy Saint Germain en Laye, Poissy, France
  81. 81. Hospital of the city of Wolfsburg, Wolfsburg, Germany
  82. 82. Toronto General Hospital, Toronto, Canada
  83. 83. Department of Neurology, Bouali University Hospital, Qazvin, Iran
  84. 84. Bordeaux University Hospital, Bordeaux, France
  85. 85. Haaglanden Medisch Centrum, The Hague, Netherlands
  86. 86. Ramon y Cajal Hospital, Madrid, Spain
  87. 87. Surrey Memorial Hospital, Surrey, Canada
  88. 88. CHU Grenoble, Grenoble, France
  89. 89. Norra Alvsborgs Lanssjukhus, Trollhattan, Sweden
  90. 90. Centenario Hospital Miguel Hidalgo, Aguascalientes, Mexico
  91. 91. Department of Neurology, Antonius Ziekenhuis, Sneek, Netherlands
  92. 92. Rijnstate Hospital Arnhem, Arnhem, Netherlands
  93. 93. Department of Neurology, Royal North Shore Hospital, Sydney, Australia
  94. 94. Ulm University Hospital, Ulm, Germany
  95. 95. University Hospital of Grenoble, Grenoble, France
  96. 96. Hospices Civils de Lyon, Lyon, France
  97. 97. Department of Neurology, Arak University of Medical Sciences, Arak, Iran
  98. 98. UNICAMP Universidade Estadual de Campinas, Campinas, Brazil
  99. 99. Hospital Universitario Professor Alberto Antunes, Universidade Federal de Alagoas (HUPAA/UFAL/EBSERH), Maceio, Brazil
  100. 100. University Hospital of Nancy, Nancy, France
  101. 101. Virgen del Rocio University Hospital, Seville, Spain
  102. 102. Instituto Panvascular de Occidente, Jalisco, Guadalajara, Mexico
  103. 103. Johannes Kepler University Linz, Linz, Austria
  104. 104. Hospital complex of Toledo, Toledo, Spain
  105. 105. Neurology Unit ASST Valcamonica, Brescia, Esine, Italy
  106. 106. Stroke Unit, Department of Neurosciences, Germans Trias i Pujol University Hospital, Badalona, Spain
  107. 107. Azienda Unita Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
  108. 108. Department of Neurosciences and Mental Health, Hospital de Santa Maria, Centro Hospitalar Universitario Lisboa Norte, University of Lisbon, Lisbon, Portugal
  109. 109. University Hospital of Poitiers, Poitiers, France
  110. 110. Department of Neurology, Centro Hospitalar Universitario Sao Joao, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Portugal
  111. 111. Sina Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
  112. 112. Institute of Neurosciences, SIMS hospital, Tamil Nadu, Chennai, India
  113. 113. Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  114. 114. Neurology and Stroke Unit, Department of Neuroscience, Bufalini Hospital, Cesena, Italy
  115. 115. Hospital de Cascais Dr. Jose de Almeida, Cascais, Portugal
  116. 116. Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  117. 117. IRCSS Ospedale Policlinico San Martino, Genoa, Italy
  118. 118. Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany
  119. 119. Firoozgar hospital, School of Medicine, Iran University of Medical sciences, Tehran, Iran
  120. 120. Department of Neurology, Lorestan University of Medical Sciences, Khorramabad, Iran
  121. 121. Sahyadri Superpeciality Hospital, Maharashtra, Pune, India
  122. 122. Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, Trivandrum, India
  123. 123. Department of Neurology, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
  124. 124. Leiden University Medical Centre, Leiden, Netherlands
  125. 125. Department of Neurology, CHU Grenoble Alpes, Grenoble, France
  126. 126. Hospital de la Cavale Blanche, CHRU de Brest, Brest, France
  127. 127. Institute of Cardiovascular Disease, Royal Holloway University of London, London, United Kingdom
  128. 128. Neurology and Stroke Unit, Cardarelli Hospital, Naples, Italy
  129. 129. Department of Neurology, Cliniques Universitaires Saint-Luc, Universite Catholique de Louvain, Hippocrate 10, Brussels, 1200, Belgium
  130. 130. Lariboisiere Hospital, Neurology Department, Assistance Publique Hopitaux de Paris, France
  131. 131. Department of Neurology, Bushehr University of medical science, Bushehr, Iran
  132. 132. Universidade Federal do Cariri, Juazeiro do Norte, Brazil
  133. 133. Department of Neurology & stroke unit, Hopital de la Cavale Blanche, CHRU de Brest (University Hospital), Universite de Bretagne Occidentale, Inserm1078, Brest, France
  134. 134. Foothills Medical Centre, Calgary, Canada
  135. 135. Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom
  136. 136. KIMS Hospital, Telangana, Hyderabad, India
  137. 137. 2nd Department of Neurology, Aristotle University of Thessaloniki, School of Medicine, AHEPA University Hospital, Greece
  138. 138. University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom
  139. 139. Department of Neurology, Division of Neuroradiology, Vascular and Interventional Radiology, Department of Radiology, Medical University of Graz, Austria
  140. 140. St John’s Medical College Hospital, Karnataka, Bengaluru, India
  141. 141. Dept. of Neurology, University Medical Center Schleswig-Holstein, Campus Kiel, Germany
  142. 142. Isfahan University of Medical Sciences (IUMS), Isfahan Neurosciences Research Center (INRC), Isfahan, Iran
  143. 143. Unidad medica de alta especialidad No. 25., Nuevo Leon, Monterrey, Mexico
  144. 144. Department of Neurology, Stroke Unit, Ospedale del Mare, ASL Napoli 1 Centro, Napoli, Italy
  145. 145. Medicana Izmir International Hospital, Izmir, Turkey
  146. 146. Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
  147. 147. Neurology, public Imam Hossein Hospital, Kermanshah, Iran
  148. 148. Department of Neurology, Firoozabadi Hospital, Iran University of Medical Sciences, Tehran, Iran
  149. 149. Institute for Clinical and Experimental Transfusion Medicine, Medical Faculty of Tuebingen, University Hospital of Tuebingen, Tuebingen, Germany
  150. 150. Department of Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
  151. 151. Department of Viroscience, Erasmus Medical Center Rotterdam, Rotterdam, Netherlands
  152. 152. Department of Clinical Neuroscience, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Sweden

Source: European Stroke Journal Published:2023


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. © European Stroke Organisation 2023.
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