Sex differences in cerebral venous sinus thrombosis after adenoviral vaccination against COVID-19

• Published in: European stroke journal Vol. 8; no. 4; pp. 1001 - 1010
• Main Authors: van de Munckhof, Anita, Kleinig, Timothy J, Field, Thalia S, Middeldorp, Saskia, Aaron, Sanjith, Borhani-Haghighi, Afshin, Arauz, Antonio, Günther, Albrecht, Wasay, Mohammad, Conforto, Adriana Bastos, Tatlisumak, Turgut, Ferro, José M, Heldner, Mirjam R, Antonenko, Kateryna, Brodard, Justine, Dizonno, Vanessa, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Sharma, Aarti R., Buture, Alina, Cervera, Alvaro, Romina Montané Baños, Ana, Tiede, Andreas, Puthuppallil, Anemon, Mengel, Annerose, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Lim Alvin Chew, Beng, Ziaadini, Bentalhoda, Varkey Maramattom, Boby, Zanferrari, Carla, Vayne, Caroline, Jacobi, Christian, Pelz, Johann, Wahl, Christoph, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, De Maistre, Emmanuel, Saxhaug Kristoffersen, Espen, Geeraerts, Thomas, Giammello, Fabrizio, D’Onofrio, Florindo, Susen, Sophie, Tsivgoulis, Georgios, Cangür, Hakan, Mozhdehipanah, Hossein, Sibon, Igor, Brar, Jaskiran, Burrow, Jim, Fernandes, João, Oen, Joyce, Schouten, Judith, Chatterton, Sophie, Althaus, Katharina, Garambois, Katia, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Humbertjean, Lisa, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Dubois, Marie-Cecile, Ghiasian, Masoud, Romoli, Michele, Saadatnia, Mohammad, Scholz, Moritz J., Kahnis, Robert, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Kumar Paramasivan, Naveen, Erat Sreedharan, Sapna, Detante, Olivier, Huet, Olivier, Scoppettuolo, Pasquale, Reiner, Peggy, Timsit, Serge, Sharma, Shyam S., Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Garcia-Talavera, Veronica, Arslan, Yıldız, Mirzaasgari, Zahra, Zamani, Zohreh, Levi, Marcel
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.12.2023
• Subjects: Cardiac and Cardiovascular Systems; CVST; Kardiologi; Original s; sex differences; VITT; sex differences; VITT; CVST
• ISSN: 2396-9873; 2396-9881; 2396-9881
• DOI: 10.1177/23969873231185213

Introduction: Cerebral venous sinus thrombosis associated with vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) is a severe disease with high mortality. There are few data on sex differences in CVST-VITT. The aim of our study was to investigate the differences in presentation, treatment, clinical course, complications, and outcome of CVST-VITT between women and men. Patients and methods: We used data from an ongoing international registry on CVST-VITT. VITT was diagnosed according to the Pavord criteria. We compared the characteristics of CVST-VITT in women and men. Results: Of 133 patients with possible, probable, or definite CVST-VITT, 102 (77%) were women. Women were slightly younger [median age 42 (IQR 28–54) vs 45 (28–56)], presented more often with coma (26% vs 10%) and had a lower platelet count at presentation [median (IQR) 50x109/L (28–79) vs 68 (30–125)] than men. The nadir platelet count was lower in women [median (IQR) 34 (19–62) vs 53 (20–92)]. More women received endovascular treatment than men (15% vs 6%). Rates of treatment with intravenous immunoglobulins were similar (63% vs 66%), as were new venous thromboembolic events (14% vs 14%) and major bleeding complications (30% vs 20%). Rates of good functional outcome (modified Rankin Scale 0-2, 42% vs 45%) and in-hospital death (39% vs 41%) did not differ. Discussion and conclusions: Three quarters of CVST-VITT patients in this study were women. Women were more severely affected at presentation, but clinical course and outcome did not differ between women and men. VITT-specific treatments were overall similar, but more women received endovascular treatment.