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Pediatric Cerebral Sinus Venous Thrombosis During the First Three Years of the SARS-CoV-2 Pandemic: A Multinational

Marcela Torres1, Allyson Schenk2, Riten Kumar3,4

  • 1Department of Hematology and Oncology, Cook Children's Hematology and Oncology Center, Fort Worth, Texas, USA.

Pediatric Blood & Cancer
|July 31, 2026
PubMed

Insights

Cerebral sinovenous thrombosis (CSVT) is a rare complication in children with COVID-19. While most patients showed improvement with anticoagulation, many experienced lingering neurological deficits, highlighting the need for further research into SARS-CoV-2

Area of Science:

  • Neurology
  • Pediatrics
  • Infectious Diseases

Background:

  • Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, is linked to thrombotic events in both adults and children.
  • Cerebral sinovenous thrombosis (CSVT) is a known complication in adult COVID-19 patients, but it is rarely reported in pediatric cases.

Purpose of the Study:

  • To investigate and describe cases of pediatric CSVT associated with SARS-CoV-2 infection.
  • To analyze the clinical characteristics, risk factors, and outcomes of children diagnosed with CSVT and COVID-19.

Main Methods:

  • The study included pediatric patients (aged 0-18 years) diagnosed with CSVT and confirmed SARS-CoV-2 infection between March 2020 and March 2023.
  • Data were collected from the International Pediatric Stroke Study, encompassing 19 eligible cases from multiple countries and institutions.

Main Results:

  • Nineteen pediatric cases of CSVT associated with SARS-CoV-2 were identified, with a median age of 9 years.
  • Thrombosis of the superficial venous system occurred in 90% of patients, with 63% having a positive hypercoagulability evaluation and 58% presenting with coinfection.
  • While 95% received antithrombotics and 80% showed CSVT resolution or improvement at follow-up, 38% had persistent neurological deficits.

Conclusions:

  • Pediatric CSVT appears to be a rare thrombotic complication of SARS-CoV-2 infection.
  • The presence of additional risk factors in all patients complicates the direct attribution of CSVT solely to SARS-CoV-2 infection.
  • Despite treatment, a significant proportion of pediatric patients experienced long-term neurological deficits following CSVT associated with COVID-19.
Abstract

Keywords:
SARS‐CoV‐2anticoagulationintracranial venous thrombosispediatric

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