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Age-Stratified Risk of Cerebral Venous Sinus Thrombosis After SARS-CoV-2 Vaccination.
Krzywicka, Katarzyna; van de Munckhof, Anita; Sánchez van Kammen, Mayte; Heldner, Mirjam R; Jood, Katarina; Lindgren, Erik; Tatlisumak, Turgut; Putaala, Jukka; Kremer Hovinga, Johanna A; Middeldorp, Saskia; Levi, Marcel M; Cordonnier, Charlotte; Arnold, Marcel; Zwinderman, Aeilko H; Ferro, José M; Coutinho, Jonathan M; Aguiar de Sousa, Diana.
Afiliação
  • Krzywicka K; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • van de Munckhof A; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Sánchez van Kammen M; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Heldner MR; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Jood K; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Lindgren E; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Tatlisumak T; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Putaala J; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Kremer Hovinga JA; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Middeldorp S; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Levi MM; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Cordonnier C; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Arnold M; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Zwinderman AH; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Ferro JM; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Coutinho JM; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
  • Aguiar de Sousa D; From the Departments of Neurology (K.K., A.v.d.M., M.S.v.K., J.M.C.) and Vascular Medicine (M.M.L.), Amsterdam University Medical Centers, University of Amsterdam, the Netherlands; Departments of Neurology (M.R.H., M.A.) and Hematology (J.A.K.H.), Inselspital, Bern University Hospital, University of
Neurology ; 98(7): e759-e768, 2022 02 15.
Article em En | MEDLINE | ID: mdl-34921101
BACKGROUND AND OBJECTIVES: Cerebral venous sinus thrombosis (CVST) as a part of the thrombosis and thrombocytopenia syndrome is a rare adverse drug reaction of severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) vaccination. Estimated background rate of CVST with thrombocytopenia is 0.1 per million per month. We assessed the age-stratified risk of CVST with and without thrombocytopenia after SARS-CoV-2 vaccination. METHODS: We estimated the absolute risk of CVST with and without thrombocytopenia within 28 days of a first dose of 4 SARS-CoV-2 vaccinations using data from the European Medicines Agency's EudraVigilance database (until June 13, 2021). As a denominator, we used data on vaccine delivery from 31 European countries. For 22.8 million adults from 25 countries, we estimated the absolute risk of CVST after the first dose of ChAdOx1 nCov-19 per age category. RESULTS: The absolute risk of CVST within 28 days of first-dose vaccination was 7.5 (95% confidence interval [CI] 6.9-8.3), 0.7 (95% CI 0.2-2.4), 0.6 (95% CI 0.5-0.7), and 0.6 (95% CI 0.3-1.1) per million of first doses of ChAdOx1 nCov-19, Ad26.COV2.S, BNT162b2, and mRNA-1273, respectively. The absolute risk of CVST with thrombocytopenia within 28 days of first dose vaccination was 4.4 (95% CI 3.9-4.9), 0.7 (95% CI 0.2-2.4), 0.0 (95% CI 0.0-0.1), and 0.0 (95% CI 0.0-0.2) per million of first doses of ChAdOx1 nCov-19, Ad26.COV2.S, BNT162b2, and mRNA-1273, respectively. In recipients of ChAdOx1 nCov-19, the absolute risk of CVST, both with and without thrombocytopenia, was the highest in the 18- to 24-year-old group (7.3 per million, 95% CI 2.8-18.8 and 3.7 per million, 95% CI 1.0-13.3, respectively). The risk of CVST with thrombocytopenia in ChAdOx1 nCov-19 recipients was the lowest in the age group ≥70 years (0.2, 95% CI 0.0-1.3). Age <60 years compared to ≥60 years was a predictor for CVST with thrombocytopenia (incidence rate ratio 5.79, 95% CI 2.98-11.24, p < 0.001). DISCUSSION: The risk of CVST with thrombocytopenia within 28 days of first-dose vaccination with ChAdOx1 nCov-19 was higher in younger age groups. The risk of CVST with thrombocytopenia was slightly increased in patients receiving Ad26.COV2.S compared with the estimated background risk. The risk of CVST with thrombocytopenia was not increased in recipients of SARS-CoV-2 mRNA vaccines.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Trombose dos Seios Intracranianos / Vacinas contra COVID-19 Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Humans / Middle aged Idioma: En Revista: Neurology Ano de publicação: 2022 Tipo de documento: Article
Texto completo
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Trombose dos Seios Intracranianos / Vacinas contra COVID-19 Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Adolescent / Adult / Aged / Humans / Middle aged Idioma: En Revista: Neurology Ano de publicação: 2022 Tipo de documento: Article