Outcomes of cerebral venous thrombosis with and without COVID-19 infection

We aimed to compare outcomes of cerebral venous thrombosis (CVT) within 2 weeks of coronavirus disease-2019 (COVID-19) infection compared to those without COVID-19.

The study included adult patients diagnosed with CVT between 2020 and 2022 in TriNetX COVID research network. They were categorized into two groups namely, CVT with COVID and CVT without COVID, based on diagnosis of COVID-19 infection within 2 weeks of CVT diagnosis. All-cause mortality, cerebrovascular and thromboembolic outcomes were assessed at one and three months. Propensity score matching was performed to control for covariates. The two groups were compared with cox proportional hazard analysis and reported as hazard ratio (HR) and 95 % confidence interval (CI).

547 patients with CVT and COVID and 10,450 patients with CVT without COVID met the study criteria. After matching, 544 patients were in each group. Patients with COVID-19 infection within 2 weeks prior to CVT diagnosis had twice higher risk of all-cause mortality [1 month: 35 (6.4 %) vs 15 (2.8 %); HR = 2.37; 95 % CI = 1.30-4.35 and at three months: 51 (9.4 %) vs 21 (3.9 %); HR = 2.49; 95 % CI = 1.50-4.14] and higher risk of complications of intracerebral hemorrhage [1 month: 12.3 % vs 8.3 %; HR = 1.50; 95 % CI = 1.01-2.24) and three months: 12.8 % vs 8.7 %; HR = 1.49; 95 % CI = 1.01-2.19)] and pulmonary embolism [1 month: 5.6 % vs 2.2 %; HR = 2.63; 95 % CI = 1.31-5.27 and 3 months: 6.0 % vs 2.5 %; HR = 2.39; 95 % CI = 1.25-4.59] compared to CVT without COVID.

COVID-19 infection increases risk of mortality, intracerebral hemorrhage and pulmonary embolism in patients with CVT.