Publicação
Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase
| Resumo: | Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0–2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94–194). Two patients died during follow-up (3% [95% CI, 1%–11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%–94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed). Conclusions: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up. |
|---|---|
| Autores principais: | van de Munckhof, Anita |
| Outros Autores: | Lindgren, Erik; Kleinig, Timothy J.; Field, Thalia S.; Cordonnier, Charlotte; Krzywicka, Katarzyna; Poli, Sven; Sánchez van Kammen, Mayte; Borhani-Haghighi, Afshin; Lemmens, Robin; Scutelnic, Adrian; Ciccone, Alfonso; Gattringer, Thomas; Wittstock, Matthias; Dizonno, Vanessa; Devroye, Annemie; Elkady, Ahmed; Günther, Albrecht; Cervera, Alvaro; Mengel, Annerose; Chew, Beng Lim Alvin; Buck, Brian; Zanferrari, Carla; Garcia-Esperon, Carlos; Jacobi, Christian; Soriano, Cristina; Michalski, Dominik; Zamani, Zohreh; Blacquiere, Dylan; Johansson, Elias; Cuadrado-Godia, Elisa; Vuillier, Fabrice; Bode, Felix J.; Caparros, François; Maier, Frank; Tsivgoulis, Georgios; Katzberg, Hans D.; Duan, Jiangang; Burrow, Jim; Pelz, Johann; Mbroh, Joshua; Oen, Joyce; Schouten, Judith; Zimmermann, Julian; Ng, Karl; Garambois, Katia; Petruzzellis, Marco; Carvalho Dias, Mariana; Ghiasian, Masoud; Romoli, Michele; Miranda, Miguel; Wronski, Miriam; Skjelland, Mona; Almasi-Dooghaee, Mostafa; Cuisenier, Pauline; Murphy, Seán; Timsit, Serge; Coutts, Shelagh B.; Schönenberger, Silvia; Nagel, Simon; Hiltunen, Sini; Chatterton, Sophie; Cox, Thomas; Bartsch, Thorsten; Shaygannejad, Vahid; Mirzaasgari, Zahra; Middeldorp, Saskia; Levi, Marcel M.; Kremer Hovinga, Johanna A.; Jood, Katarina; Tatlisumak, Turgut; Putaala, Jukka; Heldner, Mirjam R.; Arnold, Marcel; de Sousa, Diana Aguiar; Ferro, José; Coutinho, Jonathan M. |
| Assunto: | Hospitalization Intracranial thrombosis Mortality Thrombocytopenia Vaccination Venous thrombosis |
| Ano: | 2022 |
| País: | Portugal |
| Tipo de documento: | artigo |
| Tipo de acesso: | acesso aberto |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| _version_ | 1865920773134221312 |
|---|---|
| author | van de Munckhof, Anita |
| author2 | Lindgren, Erik Kleinig, Timothy J. Field, Thalia S. Cordonnier, Charlotte Krzywicka, Katarzyna Poli, Sven Sánchez van Kammen, Mayte Borhani-Haghighi, Afshin Lemmens, Robin Scutelnic, Adrian Ciccone, Alfonso Gattringer, Thomas Wittstock, Matthias Dizonno, Vanessa Devroye, Annemie Elkady, Ahmed Günther, Albrecht Cervera, Alvaro Mengel, Annerose Chew, Beng Lim Alvin Buck, Brian Zanferrari, Carla Garcia-Esperon, Carlos Jacobi, Christian Soriano, Cristina Michalski, Dominik Zamani, Zohreh Blacquiere, Dylan Johansson, Elias Cuadrado-Godia, Elisa Vuillier, Fabrice Bode, Felix J. Caparros, François Maier, Frank Tsivgoulis, Georgios Katzberg, Hans D. Duan, Jiangang Burrow, Jim Pelz, Johann Mbroh, Joshua Oen, Joyce Schouten, Judith Zimmermann, Julian Ng, Karl Garambois, Katia Petruzzellis, Marco Carvalho Dias, Mariana Ghiasian, Masoud Romoli, Michele Miranda, Miguel Wronski, Miriam Skjelland, Mona Almasi-Dooghaee, Mostafa Cuisenier, Pauline Murphy, Seán Timsit, Serge Coutts, Shelagh B. Schönenberger, Silvia Nagel, Simon Hiltunen, Sini Chatterton, Sophie Cox, Thomas Bartsch, Thorsten Shaygannejad, Vahid Mirzaasgari, Zahra Middeldorp, Saskia Levi, Marcel M. Kremer Hovinga, Johanna A. Jood, Katarina Tatlisumak, Turgut Putaala, Jukka Heldner, Mirjam R. Arnold, Marcel de Sousa, Diana Aguiar Ferro, José Coutinho, Jonathan M. |
| author2_role | author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| author_facet | van de Munckhof, Anita van de Munckhof, Anita Lindgren, Erik Kleinig, Timothy J. Field, Thalia S. Cordonnier, Charlotte Krzywicka, Katarzyna Poli, Sven Sánchez van Kammen, Mayte Borhani-Haghighi, Afshin Lemmens, Robin Scutelnic, Adrian Ciccone, Alfonso Gattringer, Thomas Wittstock, Matthias Dizonno, Vanessa Devroye, Annemie Elkady, Ahmed Günther, Albrecht Cervera, Alvaro Mengel, Annerose Chew, Beng Lim Alvin Buck, Brian Zanferrari, Carla Garcia-Esperon, Carlos Jacobi, Christian Soriano, Cristina Michalski, Dominik Zamani, Zohreh Blacquiere, Dylan Johansson, Elias Cuadrado-Godia, Elisa Vuillier, Fabrice Bode, Felix J. Caparros, François Maier, Frank Tsivgoulis, Georgios Katzberg, Hans D. Duan, Jiangang Burrow, Jim Pelz, Johann Mbroh, Joshua Oen, Joyce Schouten, Judith Zimmermann, Julian Ng, Karl Garambois, Katia Petruzzellis, Marco Carvalho Dias, Mariana Ghiasian, Masoud Romoli, Michele Miranda, Miguel Wronski, Miriam Skjelland, Mona Almasi-Dooghaee, Mostafa Cuisenier, Pauline Murphy, Seán Timsit, Serge Coutts, Shelagh B. Schönenberger, Silvia Nagel, Simon Hiltunen, Sini Chatterton, Sophie Cox, Thomas Bartsch, Thorsten Shaygannejad, Vahid Mirzaasgari, Zahra Middeldorp, Saskia Levi, Marcel M. Kremer Hovinga, Johanna A. Jood, Katarina Tatlisumak, Turgut Putaala, Jukka Heldner, Mirjam R. Arnold, Marcel de Sousa, Diana Aguiar Ferro, José Coutinho, Jonathan M. Lindgren, Erik Kleinig, Timothy J. Field, Thalia S. Cordonnier, Charlotte Krzywicka, Katarzyna Poli, Sven Sánchez van Kammen, Mayte Borhani-Haghighi, Afshin Lemmens, Robin Scutelnic, Adrian Ciccone, Alfonso Gattringer, Thomas Wittstock, Matthias Dizonno, Vanessa Devroye, Annemie Elkady, Ahmed Günther, Albrecht Cervera, Alvaro Mengel, Annerose Chew, Beng Lim Alvin Buck, Brian Zanferrari, Carla Garcia-Esperon, Carlos Jacobi, Christian Soriano, Cristina Michalski, Dominik Zamani, Zohreh Blacquiere, Dylan Johansson, Elias Cuadrado-Godia, Elisa Vuillier, Fabrice Bode, Felix J. Caparros, François Maier, Frank Tsivgoulis, Georgios Katzberg, Hans D. Duan, Jiangang Burrow, Jim Pelz, Johann Mbroh, Joshua Oen, Joyce Schouten, Judith Zimmermann, Julian Ng, Karl Garambois, Katia Petruzzellis, Marco Carvalho Dias, Mariana Ghiasian, Masoud Romoli, Michele Miranda, Miguel Wronski, Miriam Skjelland, Mona Almasi-Dooghaee, Mostafa Cuisenier, Pauline Murphy, Seán Timsit, Serge Coutts, Shelagh B. Schönenberger, Silvia Nagel, Simon Hiltunen, Sini Chatterton, Sophie Cox, Thomas Bartsch, Thorsten Shaygannejad, Vahid Mirzaasgari, Zahra Middeldorp, Saskia Levi, Marcel M. Kremer Hovinga, Johanna A. Jood, Katarina Tatlisumak, Turgut Putaala, Jukka Heldner, Mirjam R. Arnold, Marcel de Sousa, Diana Aguiar Ferro, José Coutinho, Jonathan M. |
| author_role | author |
| contributor_name_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| country_str | PT |
| creators_json_str | [{\"Person.name\":\"van de Munckhof, Anita\"},{\"Person.name\":\"Lindgren, Erik\"},{\"Person.name\":\"Kleinig, Timothy J.\"},{\"Person.name\":\"Field, Thalia S.\"},{\"Person.name\":\"Cordonnier, Charlotte\"},{\"Person.name\":\"Krzywicka, Katarzyna\"},{\"Person.name\":\"Poli, Sven\"},{\"Person.name\":\"Sánchez van Kammen, Mayte\"},{\"Person.name\":\"Borhani-Haghighi, Afshin\"},{\"Person.name\":\"Lemmens, Robin\"},{\"Person.name\":\"Scutelnic, Adrian\"},{\"Person.name\":\"Ciccone, Alfonso\"},{\"Person.name\":\"Gattringer, Thomas\"},{\"Person.name\":\"Wittstock, Matthias\"},{\"Person.name\":\"Dizonno, Vanessa\"},{\"Person.name\":\"Devroye, Annemie\"},{\"Person.name\":\"Elkady, Ahmed\"},{\"Person.name\":\"Günther, Albrecht\"},{\"Person.name\":\"Cervera, Alvaro\"},{\"Person.name\":\"Mengel, Annerose\"},{\"Person.name\":\"Chew, Beng Lim Alvin\"},{\"Person.name\":\"Buck, Brian\"},{\"Person.name\":\"Zanferrari, Carla\"},{\"Person.name\":\"Garcia-Esperon, Carlos\"},{\"Person.name\":\"Jacobi, Christian\"},{\"Person.name\":\"Soriano, Cristina\"},{\"Person.name\":\"Michalski, Dominik\"},{\"Person.name\":\"Zamani, Zohreh\"},{\"Person.name\":\"Blacquiere, Dylan\"},{\"Person.name\":\"Johansson, Elias\"},{\"Person.name\":\"Cuadrado-Godia, Elisa\"},{\"Person.name\":\"Vuillier, Fabrice\"},{\"Person.name\":\"Bode, Felix J.\"},{\"Person.name\":\"Caparros, François\"},{\"Person.name\":\"Maier, Frank\"},{\"Person.name\":\"Tsivgoulis, Georgios\"},{\"Person.name\":\"Katzberg, Hans D.\"},{\"Person.name\":\"Duan, Jiangang\"},{\"Person.name\":\"Burrow, Jim\"},{\"Person.name\":\"Pelz, Johann\"},{\"Person.name\":\"Mbroh, Joshua\"},{\"Person.name\":\"Oen, Joyce\"},{\"Person.name\":\"Schouten, Judith\"},{\"Person.name\":\"Zimmermann, Julian\"},{\"Person.name\":\"Ng, Karl\"},{\"Person.name\":\"Garambois, Katia\"},{\"Person.name\":\"Petruzzellis, Marco\"},{\"Person.name\":\"Carvalho Dias, Mariana\",\"Person.identifier.orcid\":\"0000-0002-6603-1796\"},{\"Person.name\":\"Ghiasian, Masoud\"},{\"Person.name\":\"Romoli, Michele\"},{\"Person.name\":\"Miranda, Miguel\"},{\"Person.name\":\"Wronski, Miriam\"},{\"Person.name\":\"Skjelland, Mona\"},{\"Person.name\":\"Almasi-Dooghaee, Mostafa\"},{\"Person.name\":\"Cuisenier, Pauline\"},{\"Person.name\":\"Murphy, Seán\"},{\"Person.name\":\"Timsit, Serge\"},{\"Person.name\":\"Coutts, Shelagh B.\"},{\"Person.name\":\"Schönenberger, Silvia\"},{\"Person.name\":\"Nagel, Simon\"},{\"Person.name\":\"Hiltunen, Sini\"},{\"Person.name\":\"Chatterton, Sophie\"},{\"Person.name\":\"Cox, Thomas\"},{\"Person.name\":\"Bartsch, Thorsten\"},{\"Person.name\":\"Shaygannejad, Vahid\"},{\"Person.name\":\"Mirzaasgari, Zahra\"},{\"Person.name\":\"Middeldorp, Saskia\"},{\"Person.name\":\"Levi, Marcel M.\"},{\"Person.name\":\"Kremer Hovinga, Johanna A.\"},{\"Person.name\":\"Jood, Katarina\"},{\"Person.name\":\"Tatlisumak, Turgut\"},{\"Person.name\":\"Putaala, Jukka\"},{\"Person.name\":\"Heldner, Mirjam R.\"},{\"Person.name\":\"Arnold, Marcel\"},{\"Person.name\":\"de Sousa, Diana Aguiar\",\"Person.identifier.orcid\":\"0000-0002-6702-7924\"},{\"Person.name\":\"Ferro, José\",\"Person.identifier.orcid\":\"0000-0002-2343-9097\"},{\"Person.name\":\"Coutinho, Jonathan M.\"}] |
| datacite.contributors.contributor.contributorName.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| datacite.creators.creator.creatorName.fl_str_mv | van de Munckhof, Anita Lindgren, Erik Kleinig, Timothy J. Field, Thalia S. Cordonnier, Charlotte Krzywicka, Katarzyna Poli, Sven Sánchez van Kammen, Mayte Borhani-Haghighi, Afshin Lemmens, Robin Scutelnic, Adrian Ciccone, Alfonso Gattringer, Thomas Wittstock, Matthias Dizonno, Vanessa Devroye, Annemie Elkady, Ahmed Günther, Albrecht Cervera, Alvaro Mengel, Annerose Chew, Beng Lim Alvin Buck, Brian Zanferrari, Carla Garcia-Esperon, Carlos Jacobi, Christian Soriano, Cristina Michalski, Dominik Zamani, Zohreh Blacquiere, Dylan Johansson, Elias Cuadrado-Godia, Elisa Vuillier, Fabrice Bode, Felix J. Caparros, François Maier, Frank Tsivgoulis, Georgios Katzberg, Hans D. Duan, Jiangang Burrow, Jim Pelz, Johann Mbroh, Joshua Oen, Joyce Schouten, Judith Zimmermann, Julian Ng, Karl Garambois, Katia Petruzzellis, Marco Carvalho Dias, Mariana Ghiasian, Masoud Romoli, Michele Miranda, Miguel Wronski, Miriam Skjelland, Mona Almasi-Dooghaee, Mostafa Cuisenier, Pauline Murphy, Seán Timsit, Serge Coutts, Shelagh B. Schönenberger, Silvia Nagel, Simon Hiltunen, Sini Chatterton, Sophie Cox, Thomas Bartsch, Thorsten Shaygannejad, Vahid Mirzaasgari, Zahra Middeldorp, Saskia Levi, Marcel M. Kremer Hovinga, Johanna A. Jood, Katarina Tatlisumak, Turgut Putaala, Jukka Heldner, Mirjam R. Arnold, Marcel de Sousa, Diana Aguiar Ferro, José Coutinho, Jonathan M. |
| datacite.date.Accepted.fl_str_mv | 2022-01-01T00:00:00Z |
| datacite.date.available.fl_str_mv | 2022-09-15T15:28:05Z |
| datacite.date.embargoed.fl_str_mv | 2022-09-15T15:28:05Z |
| datacite.rights.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| datacite.subjects.subject.fl_str_mv | Hospitalization Intracranial thrombosis Mortality Thrombocytopenia Vaccination Venous thrombosis |
| datacite.titles.title.fl_str_mv | Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase |
| dc.contributor.none.fl_str_mv | Repositório Científico de Acesso Aberto da ULisboa |
| dc.creator.none.fl_str_mv | van de Munckhof, Anita Lindgren, Erik Kleinig, Timothy J. Field, Thalia S. Cordonnier, Charlotte Krzywicka, Katarzyna Poli, Sven Sánchez van Kammen, Mayte Borhani-Haghighi, Afshin Lemmens, Robin Scutelnic, Adrian Ciccone, Alfonso Gattringer, Thomas Wittstock, Matthias Dizonno, Vanessa Devroye, Annemie Elkady, Ahmed Günther, Albrecht Cervera, Alvaro Mengel, Annerose Chew, Beng Lim Alvin Buck, Brian Zanferrari, Carla Garcia-Esperon, Carlos Jacobi, Christian Soriano, Cristina Michalski, Dominik Zamani, Zohreh Blacquiere, Dylan Johansson, Elias Cuadrado-Godia, Elisa Vuillier, Fabrice Bode, Felix J. Caparros, François Maier, Frank Tsivgoulis, Georgios Katzberg, Hans D. Duan, Jiangang Burrow, Jim Pelz, Johann Mbroh, Joshua Oen, Joyce Schouten, Judith Zimmermann, Julian Ng, Karl Garambois, Katia Petruzzellis, Marco Carvalho Dias, Mariana Ghiasian, Masoud Romoli, Michele Miranda, Miguel Wronski, Miriam Skjelland, Mona Almasi-Dooghaee, Mostafa Cuisenier, Pauline Murphy, Seán Timsit, Serge Coutts, Shelagh B. Schönenberger, Silvia Nagel, Simon Hiltunen, Sini Chatterton, Sophie Cox, Thomas Bartsch, Thorsten Shaygannejad, Vahid Mirzaasgari, Zahra Middeldorp, Saskia Levi, Marcel M. Kremer Hovinga, Johanna A. Jood, Katarina Tatlisumak, Turgut Putaala, Jukka Heldner, Mirjam R. Arnold, Marcel de Sousa, Diana Aguiar Ferro, José Coutinho, Jonathan M. |
| dc.date.Accepted.fl_str_mv | 2022-01-01T00:00:00Z |
| dc.date.available.fl_str_mv | 2022-09-15T15:28:05Z |
| dc.date.embargoed.fl_str_mv | 2022-09-15T15:28:05Z |
| dc.format.none.fl_str_mv | application/pdf |
| dc.identifier.none.fl_str_mv | http://hdl.handle.net/10451/54475 |
| dc.language.none.fl_str_mv | eng |
| dc.publisher.none.fl_str_mv | American Heart Association |
| dc.rights.none.fl_str_mv | http://purl.org/coar/access_right/c_abf2 |
| dc.subject.none.fl_str_mv | Hospitalization Intracranial thrombosis Mortality Thrombocytopenia Vaccination Venous thrombosis |
| dc.title.fl_str_mv | Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase |
| dc.type.none.fl_str_mv | http://purl.org/coar/resource_type/c_6501 |
| description | Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0–2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94–194). Two patients died during follow-up (3% [95% CI, 1%–11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%–94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed). Conclusions: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up. |
| dirty | 0 |
| eu_rights_str_mv | openAccess |
| format | article |
| fulltext.url.fl_str_mv | https://repositorio.ulisboa.pt/bitstreams/d523b6a2-6ef4-44f2-a125-a3cf8dc14f69/download |
| id | ul_14a49a7f57717c19cb85844b140ff803 |
| identifier.url.fl_str_mv | http://hdl.handle.net/10451/54475 |
| instacron_str | ul |
| institution | Universidade de Lisboa |
| instname_str | Universidade de Lisboa |
| language | eng |
| network_acronym_str | ul |
| network_name_str | Repositório da Universidade de Lisboa |
| oai_identifier_str | oai:repositorio.ulisboa.pt:10451/54475 |
| organization_str_mv | urn:organizationAcronym:ul |
| person_str_mv | van de Munckhof, Anita Lindgren, Erik Kleinig, Timothy J. Field, Thalia S. Cordonnier, Charlotte Krzywicka, Katarzyna Poli, Sven Sánchez van Kammen, Mayte Borhani-Haghighi, Afshin Lemmens, Robin Scutelnic, Adrian Ciccone, Alfonso Gattringer, Thomas Wittstock, Matthias Dizonno, Vanessa Devroye, Annemie Elkady, Ahmed Günther, Albrecht Cervera, Alvaro Mengel, Annerose Chew, Beng Lim Alvin Buck, Brian Zanferrari, Carla Garcia-Esperon, Carlos Jacobi, Christian Soriano, Cristina Michalski, Dominik Zamani, Zohreh Blacquiere, Dylan Johansson, Elias Cuadrado-Godia, Elisa Vuillier, Fabrice Bode, Felix J. Caparros, François Maier, Frank Tsivgoulis, Georgios Katzberg, Hans D. Duan, Jiangang Burrow, Jim Pelz, Johann Mbroh, Joshua Oen, Joyce Schouten, Judith Zimmermann, Julian Ng, Karl Garambois, Katia Petruzzellis, Marco Carvalho Dias, Mariana Carvalho Dias, Mariana http://orcid.org/0000-0002-6603-1796 0000-0002-6603-1796 Ghiasian, Masoud Romoli, Michele Miranda, Miguel Wronski, Miriam Skjelland, Mona Almasi-Dooghaee, Mostafa Cuisenier, Pauline Murphy, Seán Timsit, Serge Coutts, Shelagh B. Schönenberger, Silvia Nagel, Simon Hiltunen, Sini Chatterton, Sophie Cox, Thomas Bartsch, Thorsten Shaygannejad, Vahid Mirzaasgari, Zahra Middeldorp, Saskia Levi, Marcel M. Kremer Hovinga, Johanna A. Jood, Katarina Tatlisumak, Turgut Putaala, Jukka Heldner, Mirjam R. Arnold, Marcel de Sousa, Diana Aguiar de Sousa, Diana Aguiar https://www.ciencia-id.pt/571C-121A-5CCB 571C-121A-5CCB http://orcid.org/0000-0002-6702-7924 0000-0002-6702-7924 Ferro, José Ferro, José https://www.ciencia-id.pt/6F16-7E25-7AAF 6F16-7E25-7AAF http://orcid.org/0000-0002-2343-9097 0000-0002-2343-9097 Coutinho, Jonathan M. |
| publishDate | 2022 |
| publisher.none.fl_str_mv | American Heart Association |
| reponame_str | Repositório da Universidade de Lisboa |
| repository_id_str | urn:repositoryAcronym:ul |
| service_str_mv | urn:repositoryAcronym:ul |
| spelling | engAmerican Heart Associationpt_PTBackground: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0–2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years and 45/60 (75%) patients were women. Median follow-up time was 150 days (interquartile range, 94–194). Two patients died during follow-up (3% [95% CI, 1%–11%). Functional independence was achieved by 53/60 (88% [95% CI, 78%–94%]) patients. No new venous or arterial thrombotic events were reported. One patient developed a major bleeding during follow-up (fatal intracerebral bleed). Conclusions: In contrast to the high mortality of CVT-VITT in the acute phase, mortality among patients who survived the initial hospitalization was low, new thrombotic events did not occur, and bleeding events were rare. Approximately 9 out of 10 CVT-VITT patients who survived the acute phase were functionally independent at follow-up.application/pdfpt_PTOutcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phasevan de Munckhof, AnitaLindgren, ErikKleinig, Timothy J.Field, Thalia S.Cordonnier, CharlotteKrzywicka, KatarzynaPoli, SvenSánchez van Kammen, MayteBorhani-Haghighi, AfshinLemmens, RobinScutelnic, AdrianCiccone, AlfonsoGattringer, ThomasWittstock, MatthiasDizonno, VanessaDevroye, AnnemieElkady, AhmedGünther, AlbrechtCervera, AlvaroMengel, AnneroseChew, Beng Lim AlvinBuck, BrianZanferrari, CarlaGarcia-Esperon, CarlosJacobi, ChristianSoriano, CristinaMichalski, DominikZamani, ZohrehBlacquiere, DylanJohansson, EliasCuadrado-Godia, ElisaVuillier, FabriceBode, Felix J.Caparros, FrançoisMaier, FrankTsivgoulis, GeorgiosKatzberg, Hans D.Duan, JiangangBurrow, JimPelz, JohannMbroh, JoshuaOen, JoyceSchouten, JudithZimmermann, JulianNg, KarlGarambois, KatiaPetruzzellis, MarcoPersonalCarvalho Dias, MarianaDSpacehttp://dspace.org/items/95e4f8e1-30e3-41b9-b387-5f234ee4a333DSpacehttp://dspace.org/items/95e4f8e1-30e3-41b9-b387-5f234ee4a333Carvalho DiasMarianaORCIDhttp://orcid.org0000-0002-6603-1796Ghiasian, MasoudRomoli, MicheleMiranda, MiguelWronski, MiriamSkjelland, MonaAlmasi-Dooghaee, MostafaCuisenier, PaulineMurphy, SeánTimsit, SergeCoutts, Shelagh B.Schönenberger, SilviaNagel, SimonHiltunen, SiniChatterton, SophieCox, ThomasBartsch, ThorstenShaygannejad, VahidMirzaasgari, ZahraMiddeldorp, SaskiaLevi, Marcel M.Kremer Hovinga, Johanna A.Jood, KatarinaTatlisumak, TurgutPutaala, JukkaHeldner, Mirjam R.Arnold, MarcelPersonalde Sousa, Diana AguiarDSpacehttp://dspace.org/items/1d984575-dd95-4ca1-9092-bf6f9914ba63DSpacehttp://dspace.org/items/1d984575-dd95-4ca1-9092-bf6f9914ba63Aguiar de SousaDianaCiência IDhttps://www.ciencia-id.pt571C-121A-5CCBORCIDhttp://orcid.org0000-0002-6702-7924Researcher IDhttps://www.researcherid.comJ-4105-2013Scopus Author IDhttps://www.scopus.com55781226000PersonalFerro, JoséDSpacehttp://dspace.org/items/9a568ce6-d218-44fc-982c-0ffe7bffc197DSpacehttp://dspace.org/items/9a568ce6-d218-44fc-982c-0ffe7bffc197Morão Cabral FerroJosé ManuelCiência IDhttps://www.ciencia-id.pt6F16-7E25-7AAFORCIDhttp://orcid.org0000-0002-2343-9097Coutinho, Jonathan M.HostingInstitutionOrganizationalRepositório Científico de Acesso Aberto da ULisboae-mailmailto:repositorio@reitoria.ulisboa.ptrepositorio@reitoria.ulisboa.ptISSNIsPartOf0039-2499DOIIsPartOf10.1161/STROKEAHA.122.0395752022-09-15T15:28:05Z20222022-01-01T00:00:00ZHandlehttp://hdl.handle.net/10451/54475http://purl.org/coar/access_right/c_abf2open accessHospitalizationIntracranial thrombosisMortalityThrombocytopeniaVaccinationVenous thrombosis360598 bytesliteraturehttp://purl.org/coar/resource_type/c_6501journal articlehttp://purl.org/coar/access_right/c_abf2application/pdffulltexthttps://repositorio.ulisboa.pt/bitstreams/d523b6a2-6ef4-44f2-a125-a3cf8dc14f69/downloadStroke |
| spellingShingle | Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase van de Munckhof, Anita Hospitalization Intracranial thrombosis Mortality Thrombocytopenia Vaccination Venous thrombosis van de Munckhof, Anita Hospitalization Intracranial thrombosis Mortality Thrombocytopenia Vaccination Venous thrombosis |
| status | SINGLETON |
| subject.fl_str_mv | Hospitalization Intracranial thrombosis Mortality Thrombocytopenia Vaccination Venous thrombosis |
| title | Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase |
| title_full | Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase |
| title_fullStr | Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase |
| title_full_unstemmed | Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase |
| title_short | Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase |
| title_sort | Outcomes of cerebral venous thrombosis due to vaccine-induced immune thrombotic thrombocytopenia after the acute phase |
| topic | Hospitalization Intracranial thrombosis Mortality Thrombocytopenia Vaccination Venous thrombosis |
| topic_facet | Hospitalization Intracranial thrombosis Mortality Thrombocytopenia Vaccination Venous thrombosis |
| url | http://hdl.handle.net/10451/54475 |
| visible | 1 |