Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries
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.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
|---|---|
| Enthalten in: |
International journal of stroke : official journal of the International Stroke Society - 18(2023), 9 vom: 22. Okt., Seite 1112-1120 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
van de Munckhof, Anita [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
COVID-19 |
|---|
| Anmerkungen: |
Date Completed 30.10.2023 Date Revised 01.11.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1177/17474930231182901 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM357798724 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM357798724 | ||
| 003 | DE-627 | ||
| 005 | 20231226073354.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/17474930231182901 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1192.xml |
| 035 | |a (DE-627)NLM357798724 | ||
| 035 | |a (NLM)37277922 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a van de Munckhof, Anita |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 30.10.2023 | ||
| 500 | |a Date Revised 01.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a 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 | ||
| 520 | |a AIMS: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs | ||
| 520 | |a 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) | ||
| 520 | |a 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) | ||
| 520 | |a 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 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a CVST | |
| 650 | 4 | |a VITT | |
| 650 | 4 | |a global health | |
| 650 | 4 | |a thrombosis | |
| 650 | 4 | |a vaccination | |
| 650 | 7 | |a COVID-19 Vaccines |2 NLM | |
| 650 | 7 | |a Vaccines |2 NLM | |
| 700 | 1 | |a Borhani-Haghighi, Afshin |e verfasserin |4 aut | |
| 700 | 1 | |a Aaron, Sanjith |e verfasserin |4 aut | |
| 700 | 1 | |a Krzywicka, Katarzyna |e verfasserin |4 aut | |
| 700 | 1 | |a van Kammen, Mayte Sánchez |e verfasserin |4 aut | |
| 700 | 1 | |a Cordonnier, Charlotte |e verfasserin |4 aut | |
| 700 | 1 | |a Kleinig, Timothy J |e verfasserin |4 aut | |
| 700 | 1 | |a Field, Thalia S |e verfasserin |4 aut | |
| 700 | 1 | |a Poli, Sven |e verfasserin |4 aut | |
| 700 | 1 | |a Lemmens, Robin |e verfasserin |4 aut | |
| 700 | 1 | |a Scutelnic, Adrian |e verfasserin |4 aut | |
| 700 | 1 | |a Lindgren, Erik |e verfasserin |4 aut | |
| 700 | 1 | |a Duan, Jiangang |e verfasserin |4 aut | |
| 700 | 1 | |a Arslan, Yıldız |e verfasserin |4 aut | |
| 700 | 1 | |a van Gorp, Eric Cm |e verfasserin |4 aut | |
| 700 | 1 | |a Kremer Hovinga, Johanna A |e verfasserin |4 aut | |
| 700 | 1 | |a Günther, Albrecht |e verfasserin |4 aut | |
| 700 | 1 | |a Jood, Katarina |e verfasserin |4 aut | |
| 700 | 1 | |a Tatlisumak, Turgut |e verfasserin |4 aut | |
| 700 | 1 | |a Putaala, Jukka |e verfasserin |4 aut | |
| 700 | 1 | |a Heldner, Mirjam R |e verfasserin |4 aut | |
| 700 | 1 | |a Arnold, Marcel |e verfasserin |4 aut | |
| 700 | 1 | |a de Sousa, Diana Aguiar |e verfasserin |4 aut | |
| 700 | 1 | |a Wasay, Mohammad |e verfasserin |4 aut | |
| 700 | 1 | |a Arauz, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Conforto, Adriana Bastos |e verfasserin |4 aut | |
| 700 | 1 | |a Ferro, José M |e verfasserin |4 aut | |
| 700 | 1 | |a Coutinho, Jonathan M |e verfasserin |4 aut | |
| 700 | 0 | |a Cerebral Venous Sinus Thrombosis with Thrombocytopenia Syndrome Study Group |e verfasserin |4 aut | |
| 700 | 1 | |a Mbroh, Joshua |e investigator |4 oth | |
| 700 | 1 | |a Ciccone, Alfonso |e investigator |4 oth | |
| 700 | 1 | |a Wittstock, Matthias |e investigator |4 oth | |
| 700 | 1 | |a Zimmermann, Julian |e investigator |4 oth | |
| 700 | 1 | |a Bode, Felix J |e investigator |4 oth | |
| 700 | 1 | |a Skjelland, Mona |e investigator |4 oth | |
| 700 | 1 | |a Dizonno, Vanessa |e investigator |4 oth | |
| 700 | 1 | |a Devroye, Annemie |e investigator |4 oth | |
| 700 | 1 | |a Hiltunen, Sini |e investigator |4 oth | |
| 700 | 1 | |a Petruzzellis, Marco |e investigator |4 oth | |
| 700 | 1 | |a Bakchoul, Tamam |e investigator |4 oth | |
| 700 | 1 | |a Levi, Marcel |e investigator |4 oth | |
| 700 | 1 | |a Middeldorp, Saskia |e investigator |4 oth | |
| 700 | 1 | |a Sharma, Aarti R |e investigator |4 oth | |
| 700 | 1 | |a Ghoreishi, Abdoreza |e investigator |4 oth | |
| 700 | 1 | |a Elkady, Ahmed |e investigator |4 oth | |
| 700 | 1 | |a Negro, Alberto |e investigator |4 oth | |
| 700 | 1 | |a Gutschalk, Alexander |e investigator |4 oth | |
| 700 | 1 | |a Buture, Alina |e investigator |4 oth | |
| 700 | 1 | |a Cervera, Alvaro |e investigator |4 oth | |
| 700 | 1 | |a Paiva Nunes, Ana |e investigator |4 oth | |
| 700 | 1 | |a Romina Montané Baños, Ana |e investigator |4 oth | |
| 700 | 1 | |a Tiede, Andreas |e investigator |4 oth | |
| 700 | 1 | |a Tuladhar, Anil M |e investigator |4 oth | |
| 700 | 1 | |a Mengel, Annerose |e investigator |4 oth | |
| 700 | 1 | |a Medina, Antonio |e investigator |4 oth | |
| 700 | 1 | |a Aujayeb, Avinash |e investigator |4 oth | |
| 700 | 1 | |a Ramasamy, Balakrishnan |e investigator |4 oth | |
| 700 | 1 | |a Casolla, Barbara |e investigator |4 oth | |
| 700 | 1 | |a Spratt, Neil |e investigator |4 oth | |
| 700 | 1 | |a Ziaadini, Bentolhoda |e investigator |4 oth | |
| 700 | 1 | |a Varkey Maramattom, Boby |e investigator |4 oth | |
| 700 | 1 | |a Buck, Brian |e investigator |4 oth | |
| 700 | 1 | |a Garcia-Esperon, Carlos |e investigator |4 oth | |
| 700 | 1 | |a Vayne, Caroline |e investigator |4 oth | |
| 700 | 1 | |a Jacobi, Christian |e investigator |4 oth | |
| 700 | 1 | |a Pfrepper, Christian |e investigator |4 oth | |
| 700 | 1 | |a Bal, Deepti |e investigator |4 oth | |
| 700 | 1 | |a Sergio Zimatore, Domenico |e investigator |4 oth | |
| 700 | 1 | |a Michalski, Dominik |e investigator |4 oth | |
| 700 | 1 | |a Blacquiere, Dylan |e investigator |4 oth | |
| 700 | 1 | |a Johansson, Elias |e investigator |4 oth | |
| 700 | 1 | |a Cuadrado-Godia, Elisa |e investigator |4 oth | |
| 700 | 1 | |a Sadeghi-Hokmabadi, Elyar |e investigator |4 oth | |
| 700 | 1 | |a Carrera, Emmanuel |e investigator |4 oth | |
| 700 | 1 | |a Maistre, Emmanuel De |e investigator |4 oth | |
| 700 | 1 | |a Saxhaug Kristoffersen, Espen |e investigator |4 oth | |
| 700 | 1 | |a Hooshmandi, Etrat |e investigator |4 oth | |
| 700 | 1 | |a Bonneville, Fabrice |e investigator |4 oth | |
| 700 | 1 | |a Vuillier, Fabrice |e investigator |4 oth | |
| 700 | 1 | |a Giammello, Fabrizio |e investigator |4 oth | |
| 700 | 1 | |a D'Onofrio, Florindo |e investigator |4 oth | |
| 700 | 1 | |a Tsivgoulis, Georgios |e investigator |4 oth | |
| 700 | 1 | |a Gulli, Giosue |e investigator |4 oth | |
| 700 | 1 | |a Katzberg, Hans |e investigator |4 oth | |
| 700 | 1 | |a Sibon, Igor |e investigator |4 oth | |
| 700 | 1 | |a Baharoglu, Irem |e investigator |4 oth | |
| 700 | 1 | |a Masjuan, Jaime |e investigator |4 oth | |
| 700 | 1 | |a Fernandes, João |e investigator |4 oth | |
| 700 | 1 | |a Pelz, Johann |e investigator |4 oth | |
| 700 | 1 | |a Octavio López Esparza, Jorge |e investigator |4 oth | |
| 700 | 1 | |a Schouten, Judith |e investigator |4 oth | |
| 700 | 1 | |a Ng, Karl |e investigator |4 oth | |
| 700 | 1 | |a Derex, Laurent |e investigator |4 oth | |
| 700 | 1 | |a Puy, Laurent |e investigator |4 oth | |
| 700 | 1 | |a Poorsaadat, Leila |e investigator |4 oth | |
| 700 | 1 | |a Valler, Lenise |e investigator |4 oth | |
| 700 | 1 | |a Januzi de Almeida Rocha, Letícia |e investigator |4 oth | |
| 700 | 1 | |a Murillo-Bonilla, Luis |e investigator |4 oth | |
| 700 | 1 | |a Kellermair, Lukas |e investigator |4 oth | |
| 700 | 1 | |a Morin Martin, Mar |e investigator |4 oth | |
| 700 | 1 | |a Sofia Cotelli, Maria |e investigator |4 oth | |
| 700 | 1 | |a Hernandez Perez, Maria |e investigator |4 oth | |
| 700 | 1 | |a Zedde, Marialuisa |e investigator |4 oth | |
| 700 | 1 | |a Carvalho Dias, Mariana |e investigator |4 oth | |
| 700 | 1 | |a Carvalho, Marta |e investigator |4 oth | |
| 700 | 1 | |a Ghiasian, Masoud |e investigator |4 oth | |
| 700 | 1 | |a Umaiorubahan, Meenakshisundaram |e investigator |4 oth | |
| 700 | 1 | |a Roozbeh, Mehrdad |e investigator |4 oth | |
| 700 | 1 | |a Romoli, Michele |e investigator |4 oth | |
| 700 | 1 | |a Miranda, Miguel |e investigator |4 oth | |
| 700 | 1 | |a Wronski, Miriam |e investigator |4 oth | |
| 700 | 1 | |a Saadatnia, Mohammad |e investigator |4 oth | |
| 700 | 1 | |a Bandettini di Poggio, Monica |e investigator |4 oth | |
| 700 | 1 | |a Almasi-Dooghaee, Mostafa |e investigator |4 oth | |
| 700 | 1 | |a Hoseininejad Mir, Nahid |e investigator |4 oth | |
| 700 | 1 | |a Ichaporia, Nasli R |e investigator |4 oth | |
| 700 | 1 | |a Kumar Paramasivan, Naveen |e investigator |4 oth | |
| 700 | 1 | |a Raposo, Nicolas |e investigator |4 oth | |
| 700 | 1 | |a Fadakar, Nima |e investigator |4 oth | |
| 700 | 1 | |a Kruyt, Nyika |e investigator |4 oth | |
| 700 | 1 | |a Detante, Olivier |e investigator |4 oth | |
| 700 | 1 | |a Sharma, Pankaj |e investigator |4 oth | |
| 700 | 1 | |a Candelaresi, Paolo |e investigator |4 oth | |
| 700 | 1 | |a Scoppettuolo, Pasquale |e investigator |4 oth | |
| 700 | 1 | |a Reiner, Peggy |e investigator |4 oth | |
| 700 | 1 | |a Sylaja, P N |e investigator |4 oth | |
| 700 | 1 | |a Kumar Karunakaran, Ravi |e investigator |4 oth | |
| 700 | 1 | |a Vieira, Ricardo |e investigator |4 oth | |
| 700 | 1 | |a Kern, Rolf |e investigator |4 oth | |
| 773 | 0 | 8 | |i Enthalten in |t International journal of stroke : official journal of the International Stroke Society |d 2006 |g 18(2023), 9 vom: 22. Okt., Seite 1112-1120 |w (DE-627)NLM181612585 |x 1747-4949 |7 nnns |
| 773 | 1 | 8 | |g volume:18 |g year:2023 |g number:9 |g day:22 |g month:10 |g pages:1112-1120 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/17474930231182901 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 18 |j 2023 |e 9 |b 22 |c 10 |h 1112-1120 | ||