ABSTRACT
Background@#and Purpose Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. @*Methods@#We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). @*Results@#There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. @*Conclusions@#During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.
ABSTRACT
Background and Objective: Multiple sclerosis (MS) is variable in its prevalence and manifestations in different regions of the world. Iran is one of the most populous countries in Middle East, it is important to have a better understanding of the epidemiology and clinical pattern of MS in different parts of Iran. Although Iran is said to be located in the low-risk area, recent studies have shown that the prevalence of MS in Iran may be much higher than what was previously thought. This study determines the current prevalence and clinical features of MS in East Azerbaijan province, North West Iran. Methods: All patients for this study were MS cases listed in the Committee for Diagnosis and Treatment of MS (CDTMS) registry. The study patients were all residents of East Azerbaijan Province who were diagnosed with MS by neurologists. Results: Out of one thousand cases, 269 were males (26.9%) and 731 females (73.1%).The female/male ratio was 2.7. The crude prevalence of MS in East Azerbaijan was 27.7/100,000 population. The mean age (SD) of patients was 33.4 (8.9) years. The relapse-remitting form of disease was seen in 67.7% of patients; primary-progressive disease in 2.8%; and secondary progressive disease in 11.2%. Conclusion: Our study suggests that MS prevalence in North West Iran lies in the medium frequency range.