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

Author: Scutelnic, Adrian, van de Munckhof, Anita, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Lindgren, Erik, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Middeldorp, Saskia, Aaron, Sanjith, Borhani-Haghighi, Afshin, Arauz, Antonio, Kremer Hovinga, Johanna A., Günther, Albrecht, Putaala, Jukka, Wasay, Mohammad, Conforto, Adriana Bastos, de Sousa, Diana Aguiar, Jood, Katarina, Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Heldner, Mirjam R., Antonenko, Kateryna, Mbroh, Joshua, Brodard, Justine, Hooshmandi, Etrat, Dizonno, Vanessa, Devroye, Annemie, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Duan, Jiangang, Hiltunen, Sini, Zuurbier, Susanna M., Petruzzellis, Marco, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Schoenenberger, Silvia, Nagel, Simon, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Puthuppallil, Anemon, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Lim Alvin Chew, Beng, Ziaadini, Bentalhoda, Varkey Maramattom, Boby, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Jacobi, Christian, Pfrepper, Christian, Pelz, Johann, Wahl, Christoph, Kern, Rolf, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, De Maistre, Emmanuel, Saxhaug Kristoffersen, Espen, Bonneville, Fabrice, Geeraerts, Thomas, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Grillo, Francesco, Caparros, François, Susen, Sophie, Maier, Frank, Tsivgoulis, Georgios, Gulli, Giosue, Frisullo, Giovanni, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Mozhdehipanah, Hossein, Sibon, Igor, Baharoglu, M. Irem, Masjuan, Jaime, Brar, Jaskiran, Payen, Jean Francois, Burrow, Jim, Fernandes, João, Octavio López Esparza, Jorge, Oen, Joyce, Schouten, Judith, Ng, Karl, Chatterton, Sophie, Wronski, Miriam, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Dubois, Marie Cecile, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Kumar Karunakaran, Ravi, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Scholz, Moritz J., Kahnis, Robert, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Erat Sreedharan, Sapna, Sylaja, P. N., Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Cuisenier, Pauline, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Nemati, Reza, Vieira, Ricardo, Goh, Rudy, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Bal, Simerpreet, Kaul, Subhash, Karapanayiotides, Theodoros, Cox, Thomas, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Garcia-Talavera, Veronica, Palma, Vincenzo, Arslan, Yıldız, Mirzaasgari, Zahra, Yavari, Zeinab, Zamani, Zohreh, Bakchoul, Tamam, Levi, Marcel, van Gorp, Eric C.M., Scutelnic, Adrian, van de Munckhof, Anita, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Lindgren, Erik, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Middeldorp, Saskia, Aaron, Sanjith, Borhani-Haghighi, Afshin, Arauz, Antonio, Kremer Hovinga, Johanna A., Günther, Albrecht, Putaala, Jukka, Wasay, Mohammad, Conforto, Adriana Bastos, de Sousa, Diana Aguiar, Jood, Katarina, Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Heldner, Mirjam R., Antonenko, Kateryna, Mbroh, Joshua, Brodard, Justine, Hooshmandi, Etrat, Dizonno, Vanessa, Devroye, Annemie, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Duan, Jiangang, Hiltunen, Sini, Zuurbier, Susanna M., Petruzzellis, Marco, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Schoenenberger, Silvia, Nagel, Simon, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Puthuppallil, Anemon, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Lim Alvin Chew, Beng, Ziaadini, Bentalhoda, Varkey Maramattom, Boby, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Jacobi, Christian, Pfrepper, Christian, Pelz, Johann, Wahl, Christoph, Kern, Rolf, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, De Maistre, Emmanuel, Saxhaug Kristoffersen, Espen, Bonneville, Fabrice, Geeraerts, Thomas, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Grillo, Francesco, Caparros, François, Susen, Sophie, Maier, Frank, Tsivgoulis, Georgios, Gulli, Giosue, Frisullo, Giovanni, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Mozhdehipanah, Hossein, Sibon, Igor, Baharoglu, M. Irem, Masjuan, Jaime, Brar, Jaskiran, Payen, Jean Francois, Burrow, Jim, Fernandes, João, Octavio López Esparza, Jorge, Oen, Joyce, Schouten, Judith, Ng, Karl, Chatterton, Sophie, Wronski, Miriam, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Dubois, Marie Cecile, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Kumar Karunakaran, Ravi, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Scholz, Moritz J., Kahnis, Robert, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Erat Sreedharan, Sapna, Sylaja, P. N., Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Cuisenier, Pauline, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Nemati, Reza, Vieira, Ricardo, Goh, Rudy, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Bal, Simerpreet, Kaul, Subhash, Karapanayiotides, Theodoros, Cox, Thomas, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Shaygannejad, Vahid, Garcia-Talavera, Veronica, Palma, Vincenzo, Arslan, Yıldız, Mirzaasgari, Zahra, Yavari, Zeinab, Zamani, Zohreh, Bakchoul, Tamam, Levi, Marcel, and van Gorp, Eric C.M.
Abstract: 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.
Published: 2023

2. Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries

Author: van de Munckhof, Anita, Borhani-Haghighi, Afshin, Aaron, Sanjith, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Scutelnic, Adrian, Lindgren, Erik, Duan, Jiangang, Arslan, Yıldız, van Gorp, Eric C.M., Kremer Hovinga, Johanna A., Günther, Albrecht, Jood, Katarina, Tatlisumak, Turgut, Putaala, Jukka, Heldner, Mirjam R., Arnold, Marcel, de Sousa, Diana Aguiar, Wasay, Mohammad, Arauz, Antonio, Conforto, Adriana Bastos, Ferro, José M., Coutinho, Jonathan M., Mbroh, Joshua, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Dizonno, Vanessa, Devroye, Annemie, Hiltunen, Sini, Petruzzellis, Marco, Bakchoul, Tamam, Levi, Marcel, Middeldorp, Saskia, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Spratt, Neil, Ziaadini, Bentolhoda, Varkey Maramattom, Boby, Buck, Brian, Garcia-Esperon, Carlos, Vayne, Caroline, Jacobi, Christian, Pfrepper, Christian, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, Maistre, Emmanuel De, Saxhaug Kristoffersen, Espen, Hooshmandi, Etrat, Bonneville, Fabrice, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Tsivgoulis, Georgios, Gulli, Giosue, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Masjuan, Jaime, Fernandes, João, Pelz, Johann, Octavio López Esparza, Jorge, Schouten, Judith, Ng, Karl, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Wronski, Miriam, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Sylaja, P. N., Kumar Karunakaran, Ravi, Vieira, Ricardo, Kern, Rolf, Goh, Rudy, Erat Sreedharan, Sapna, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Schoenenberger, Silvia, Nagel, Simon, Kaul, Subhash, Karapanayiotides, Theodoros, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Palma, Vincenzo, Mirzaasgari, Zahra, Zamani, Zohreh, Mirahmadizadeh, Alireza, Gutierrez-Romero, Alonso, Iván Valdes-Ferrer, Ivan, Elizabeth Ceballos-Liceaga, Santa, Maria Santibañez-Copado, Ana, van de Munckhof, Anita, Borhani-Haghighi, Afshin, Aaron, Sanjith, Krzywicka, Katarzyna, van Kammen, Mayte Sánchez, Cordonnier, Charlotte, Kleinig, Timothy J., Field, Thalia S., Poli, Sven, Lemmens, Robin, Scutelnic, Adrian, Lindgren, Erik, Duan, Jiangang, Arslan, Yıldız, van Gorp, Eric C.M., Kremer Hovinga, Johanna A., Günther, Albrecht, Jood, Katarina, Tatlisumak, Turgut, Putaala, Jukka, Heldner, Mirjam R., Arnold, Marcel, de Sousa, Diana Aguiar, Wasay, Mohammad, Arauz, Antonio, Conforto, Adriana Bastos, Ferro, José M., Coutinho, Jonathan M., Mbroh, Joshua, Ciccone, Alfonso, Wittstock, Matthias, Zimmermann, Julian, Bode, Felix J., Skjelland, Mona, Dizonno, Vanessa, Devroye, Annemie, Hiltunen, Sini, Petruzzellis, Marco, Bakchoul, Tamam, Levi, Marcel, Middeldorp, Saskia, Sharma, Aarti R., Ghoreishi, Abdoreza, Elkady, Ahmed, Negro, Alberto, Gutschalk, Alexander, Buture, Alina, Cervera, Alvaro, Paiva Nunes, Ana, Romina Montané Baños, Ana, Tiede, Andreas, Tuladhar, Anil M., Mengel, Annerose, Medina, Antonio, Aujayeb, Avinash, Ramasamy, Balakrishnan, Casolla, Barbara, Spratt, Neil, Ziaadini, Bentolhoda, Varkey Maramattom, Boby, Buck, Brian, Garcia-Esperon, Carlos, Vayne, Caroline, Jacobi, Christian, Pfrepper, Christian, Bal, Deepti, Sergio Zimatore, Domenico, Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, Sadeghi-Hokmabadi, Elyar, Carrera, Emmanuel, Maistre, Emmanuel De, Saxhaug Kristoffersen, Espen, Hooshmandi, Etrat, Bonneville, Fabrice, Vuillier, Fabrice, Giammello, Fabrizio, D’Onofrio, Florindo, Tsivgoulis, Georgios, Gulli, Giosue, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Masjuan, Jaime, Fernandes, João, Pelz, Johann, Octavio López Esparza, Jorge, Schouten, Judith, Ng, Karl, Derex, Laurent, Puy, Laurent, Poorsaadat, Leila, Valler, Lenise, Januzi de Almeida Rocha, Letícia, Murillo-Bonilla, Luis, Kellermair, Lukas, Morin Martin, Mar, Sofia Cotelli, Maria, Hernandez Perez, Maria, Zedde, Marialuisa, Carvalho Dias, Mariana, Carvalho, Marta, Ghiasian, Masoud, Umaiorubahan, Meenakshisundaram, Roozbeh, Mehrdad, Romoli, Michele, Miranda, Miguel, Wronski, Miriam, Saadatnia, Mohammad, Bandettini di Poggio, Monica, Almasi-Dooghaee, Mostafa, Hoseininejad Mir, Nahid, Ichaporia, Nasli R., Kumar Paramasivan, Naveen, Raposo, Nicolas, Fadakar, Nima, Kruyt, Nyika, Detante, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Scoppettuolo, Pasquale, Reiner, Peggy, Sylaja, P. N., Kumar Karunakaran, Ravi, Vieira, Ricardo, Kern, Rolf, Goh, Rudy, Erat Sreedharan, Sapna, Murphy, Seán, Timsit, Serge, Coutts, Shelagh, Sharma, Shyam S., Schoenenberger, Silvia, Nagel, Simon, Kaul, Subhash, Karapanayiotides, Theodoros, Gattringer, Thomas, Mathew, Thomas, Bartsch, Thorsten, Palma, Vincenzo, Mirzaasgari, Zahra, Zamani, Zohreh, Mirahmadizadeh, Alireza, Gutierrez-Romero, Alonso, Iván Valdes-Ferrer, Ivan, Elizabeth Ceballos-Liceaga, Santa, and Maria Santibañez-Copado, Ana
Abstract: Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs. Aims: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs. Methods: We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs). Results: Until August 2022, 228 CVST cases were reported, of which 63 were from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these 63, 32 (51%) met the VITT criteria, compared to 103 of 165 (62%) from HICs. Only 5 of the 32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-platelet factor 4 antibodies were often not tested. The median age was 26 (interquartile range [IQR] 20–37) versus 47 (IQR 32–58) years, and the proportion of women was 25 of 32 (78%) versus 77 of 103 (75%) in MICs versus HICs, respectively. Patients from MICs were diagnosed later than patients from HICs (1/32 [3%] vs. 65/103 [63%] diagnosed before May 2021). Clinical manifestations, including intracranial hemorrhage, were largely similar as was intravenous immunoglobulin use. In-hospital mortality was lower in MICs (7/31 [23%, 95% confidence interval (CI) 11–40]) than in HICs (44/102 [43%, 95% CI 34–53], p = 0.039). Conclusions: The number of CVST-VITT cases reported from LMICs was small despite the widespread use of adenoviral vaccines. Clinical manifestations and treatment of CVST-VITT cases were largely similar in MICs and HICs, while mortality was lower in patients from MICs.
Published: 2023

3. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
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4. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
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5. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

Author: Scutelnic, A., Krzywicka, K., Mbroh, J., Munckhof, A. van de, Kammen, M.S.V., Sousa, D.A. de, Lindgren, E., Jood, K., Günther, A., Hiltunen, S., Putaala, J., Tiede, A., Maier, F., Kern, R., Bartsch, T., Althaus, K., Ciccone, A., Wiedmann, M., Skjelland, M., Medina, A., Cuadrado-Godia, E., Cox, T., Aujayeb, A., Raposo, N., Garambois, K., Payen, J.F., Vuillier, F., Franchineau, G., Timsit, S., Bougon, D., Dubois, M.C., Tawa, A., Tracol, C., Maistre, E. De, Bonneville, F., Vayne, C., Mengel, A., Michalski, D., Pelz, J., Wittstock, M., Bode, F., Zimmermann, J., Schouten, J., Buture, A., Murphy, S., Palma, V., Negro, A., Gutschalk, A., Nagel, S., Schoenenberger, S., Frisullo, G., Zanferrari, C., Grillo, F., Giammello, F., Martin, M.M., Cervera, A., Burrow, J., Esperon, C.G., Chew, B.L.A., Kleinig, T.J., Soriano, C., Zimatore, D.S., Petruzzellis, M., Elkady, A., Miranda, M.S., Fernandes, J., Vogel, A., Johansson, E., Philip, A.P., Coutts, S.B., Bal, S., Buck, B., Legault, C., Blacquiere, D., Katzberg, H.D., Field, T.S., Dizonno, V., Gattringer, T., Jacobi, C., Devroye, A., Lemmens, R., Kristoffersen, E.S., Poggio, M.B. di, Ghiasian, M., Karapanayiotides, T., Chatterton, S., Wronski, M., Ng, K., Kahnis, R., Geeraerts, T., Reiner, P., Cordonnier, C., Middeldorp, S., Levi, M., Gorp, E.C. van, Beek, D van, Brodard, J., Kremer Hovinga, J.A., Kruip, M., Tatlisumak, T., Poli, S., Heldner, M.R., Scutelnic, A., Krzywicka, K., Mbroh, J., Munckhof, A. van de, Kammen, M.S.V., Sousa, D.A. de, Lindgren, E., Jood, K., Günther, A., Hiltunen, S., Putaala, J., Tiede, A., Maier, F., Kern, R., Bartsch, T., Althaus, K., Ciccone, A., Wiedmann, M., Skjelland, M., Medina, A., Cuadrado-Godia, E., Cox, T., Aujayeb, A., Raposo, N., Garambois, K., Payen, J.F., Vuillier, F., Franchineau, G., Timsit, S., Bougon, D., Dubois, M.C., Tawa, A., Tracol, C., Maistre, E. De, Bonneville, F., Vayne, C., Mengel, A., Michalski, D., Pelz, J., Wittstock, M., Bode, F., Zimmermann, J., Schouten, J., Buture, A., Murphy, S., Palma, V., Negro, A., Gutschalk, A., Nagel, S., Schoenenberger, S., Frisullo, G., Zanferrari, C., Grillo, F., Giammello, F., Martin, M.M., Cervera, A., Burrow, J., Esperon, C.G., Chew, B.L.A., Kleinig, T.J., Soriano, C., Zimatore, D.S., Petruzzellis, M., Elkady, A., Miranda, M.S., Fernandes, J., Vogel, A., Johansson, E., Philip, A.P., Coutts, S.B., Bal, S., Buck, B., Legault, C., Blacquiere, D., Katzberg, H.D., Field, T.S., Dizonno, V., Gattringer, T., Jacobi, C., Devroye, A., Lemmens, R., Kristoffersen, E.S., Poggio, M.B. di, Ghiasian, M., Karapanayiotides, T., Chatterton, S., Wronski, M., Ng, K., Kahnis, R., Geeraerts, T., Reiner, P., Cordonnier, C., Middeldorp, S., Levi, M., Gorp, E.C. van, Beek, D van, Brodard, J., Kremer Hovinga, J.A., Kruip, M., Tatlisumak, T., Poli, S., and Heldner, M.R.
Abstract: Contains fulltext : 282309.pdf (Publisher’s version ) (Open Access), OBJECTIVE: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. METHODS: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. RESULTS: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16-1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06-0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24-2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74-6.54). CONCLUSIONS: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT. ANN NEUROL
Published: 2022

6. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

Author: Scutelnic, A., Krzywicka, K., Mbroh, J., Munckhof, A. van de, Kammen, M.S.V., Sousa, D.A. de, Lindgren, E., Jood, K., Günther, A., Hiltunen, S., Putaala, J., Tiede, A., Maier, F., Kern, R., Bartsch, T., Althaus, K., Ciccone, A., Wiedmann, M., Skjelland, M., Medina, A., Cuadrado-Godia, E., Cox, T., Aujayeb, A., Raposo, N., Garambois, K., Payen, J.F., Vuillier, F., Franchineau, G., Timsit, S., Bougon, D., Dubois, M.C., Tawa, A., Tracol, C., Maistre, E. De, Bonneville, F., Vayne, C., Mengel, A., Michalski, D., Pelz, J., Wittstock, M., Bode, F., Zimmermann, J., Schouten, J., Buture, A., Murphy, S., Palma, V., Negro, A., Gutschalk, A., Nagel, S., Schoenenberger, S., Frisullo, G., Zanferrari, C., Grillo, F., Giammello, F., Martin, M.M., Cervera, A., Burrow, J., Esperon, C.G., Chew, B.L.A., Kleinig, T.J., Soriano, C., Zimatore, D.S., Petruzzellis, M., Elkady, A., Miranda, M.S., Fernandes, J., Vogel, A., Johansson, E., Philip, A.P., Coutts, S.B., Bal, S., Buck, B., Legault, C., Blacquiere, D., Katzberg, H.D., Field, T.S., Dizonno, V., Gattringer, T., Jacobi, C., Devroye, A., Lemmens, R., Kristoffersen, E.S., Poggio, M.B. di, Ghiasian, M., Karapanayiotides, T., Chatterton, S., Wronski, M., Ng, K., Kahnis, R., Geeraerts, T., Reiner, P., Cordonnier, C., Middeldorp, S., Levi, M., Gorp, E.C. van, Beek, D van, Brodard, J., Kremer Hovinga, J.A., Kruip, M., Tatlisumak, T., Poli, S., Heldner, M.R., Scutelnic, A., Krzywicka, K., Mbroh, J., Munckhof, A. van de, Kammen, M.S.V., Sousa, D.A. de, Lindgren, E., Jood, K., Günther, A., Hiltunen, S., Putaala, J., Tiede, A., Maier, F., Kern, R., Bartsch, T., Althaus, K., Ciccone, A., Wiedmann, M., Skjelland, M., Medina, A., Cuadrado-Godia, E., Cox, T., Aujayeb, A., Raposo, N., Garambois, K., Payen, J.F., Vuillier, F., Franchineau, G., Timsit, S., Bougon, D., Dubois, M.C., Tawa, A., Tracol, C., Maistre, E. De, Bonneville, F., Vayne, C., Mengel, A., Michalski, D., Pelz, J., Wittstock, M., Bode, F., Zimmermann, J., Schouten, J., Buture, A., Murphy, S., Palma, V., Negro, A., Gutschalk, A., Nagel, S., Schoenenberger, S., Frisullo, G., Zanferrari, C., Grillo, F., Giammello, F., Martin, M.M., Cervera, A., Burrow, J., Esperon, C.G., Chew, B.L.A., Kleinig, T.J., Soriano, C., Zimatore, D.S., Petruzzellis, M., Elkady, A., Miranda, M.S., Fernandes, J., Vogel, A., Johansson, E., Philip, A.P., Coutts, S.B., Bal, S., Buck, B., Legault, C., Blacquiere, D., Katzberg, H.D., Field, T.S., Dizonno, V., Gattringer, T., Jacobi, C., Devroye, A., Lemmens, R., Kristoffersen, E.S., Poggio, M.B. di, Ghiasian, M., Karapanayiotides, T., Chatterton, S., Wronski, M., Ng, K., Kahnis, R., Geeraerts, T., Reiner, P., Cordonnier, C., Middeldorp, S., Levi, M., Gorp, E.C. van, Beek, D van, Brodard, J., Kremer Hovinga, J.A., Kruip, M., Tatlisumak, T., Poli, S., and Heldner, M.R.
Abstract: Contains fulltext : 282309.pdf (Publisher’s version ) (Open Access), OBJECTIVE: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. METHODS: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. RESULTS: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16-1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06-0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24-2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74-6.54). CONCLUSIONS: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT. ANN NEUROL
Published: 2022

7. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
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8. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C.M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J.H.A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C.M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J.H.A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing
Published: 2022

9. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
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10. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

Author: Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, Heldner, Mirjam R., Scutelnic, Adrian, Krzywicka, Katarzyna, Mbroh, Joshua, van de Munckhof, Anita, van Kammen, Mayte Sánchez, de Sousa, Diana Aguiar, Lindgren, Erik, Jood, Katarina, Günther, Albrecht, Hiltunen, Sini, Putaala, Jukka, Tiede, Andreas, Maier, Frank, Kern, Rolf, Bartsch, Thorsten, Althaus, Katharina, Ciccone, Alfonso, Wiedmann, Markus, Skjelland, Mona, Medina, Antonio, Cuadrado-Godia, Elisa, Cox, Thomas, Aujayeb, Avinash, Raposo, Nicolas, Garambois, Katia, Payen, Jean-Francois, Vuillier, Fabrice, Franchineau, Guillaume, Timsit, Serge, Bougon, David, Dubois, Marie-Cécile, Tawa, Audrey, Tracol, Clement, De Maistre, Emmanuel, Bonneville, Fabrice, Vayne, Caroline, Mengel, Annerose, Michalski, Dominik, Pelz, Johann, Wittstock, Matthias, Bode, Felix, Zimmermann, Julian, Schouten, Judith, Buture, Alina, Murphy, Sean, Palma, Vincenzo, Negro, Alberto, Gutschalk, Alexander, Nagel, Simon, Schoenenberger, Silvia, Frisullo, Giovanni, Zanferrari, Carla, Grillo, Francesco, Giammello, Fabrizio, Martin, Mar Morin, Cervera, Alvaro, Burrow, Jim, Esperon, Carlos Garcia, Chew, Beng Lim Alvin, Kleinig, Timothy J., Soriano, Cristina, Zimatore, Domenico S., Petruzzellis, Marco, Elkady, Ahmed, Miranda, Miguel S., Fernandes, João, Vogel, Åslög Hellström, Johansson, Elias, Philip, Anemon Puthuppallil, Coutts, Shelagh B., Bal, Simerpreet, Buck, Brian, Legault, Catherine, Blacquiere, Dylan, Katzberg, Hans D., Field, Thalia S., Dizonno, Vanessa, Gattringer, Thomas, Jacobi, Christian, Devroye, Annemie, Lemmens, Robin, Kristoffersen, Espen Saxhaug, di Poggio, Monica Bandettini, Ghiasian, Masoud, Karapanayiotides, Theodoros, Chatterton, Sophie, Wronski, Miriam, Ng, Karl, Kahnis, Robert, Geeraerts, Thomas, Reiner, Peggy, Cordonnier, Charlotte, Middeldorp, Saskia, Levi, Marcel, van Gorp, Eric C. M., van de Beek, Diederik, Brodard, Justine, Kremer Hovinga, Johanna A., Kruip, Marieke J. H. A., Tatlisumak, Turgut, Ferro, José M., Coutinho, Jonathan M., Arnold, Marcel, Poli, Sven, and Heldner, Mirjam R.
Abstract: Objective: Cerebral venous thrombosis (CVT) caused by vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare adverse effect of adenovirus-based severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) vaccines. In March 2021, after autoimmune pathogenesis of VITT was discovered, treatment recommendations were developed. These comprised immunomodulation, non-heparin anticoagulants, and avoidance of platelet transfusion. The aim of this study was to evaluate adherence to these recommendations and its association with mortality. Methods: We used data from an international prospective registry of patients with CVT after the adenovirus-based SARS-CoV-2 vaccination. We analyzed possible, probable, or definite VITT-CVT cases included until January 18, 2022. Immunomodulation entailed administration of intravenous immunoglobulins and/or plasmapheresis. Results: Ninety-nine patients with VITT-CVT from 71 hospitals in 17 countries were analyzed. Five of 38 (13%), 11 of 24 (46%), and 28 of 37 (76%) of the patients diagnosed in March, April, and from May onward, respectively, were treated in-line with VITT recommendations (p < 0.001). Overall, treatment according to recommendations had no statistically significant influence on mortality (14/44 [32%] vs 29/55 [52%], adjusted odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.16–1.19). However, patients who received immunomodulation had lower mortality (19/65 [29%] vs 24/34 [70%], adjusted OR = 0.19, 95% CI = 0.06–0.58). Treatment with non-heparin anticoagulants instead of heparins was not associated with lower mortality (17/51 [33%] vs 13/35 [37%], adjusted OR = 0.70, 95% CI = 0.24–2.04). Mortality was also not significantly influenced by platelet transfusion (17/27 [63%] vs 26/72 [36%], adjusted OR = 2.19, 95% CI = 0.74–6.54). Conclusions: In patients with VITT-CVT, adherence to VITT treatment recommendations improved over time. Immunomodulation seems crucial for reducing mortality of VITT-CVT., DEAL
Published: 2022
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11. Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

Author: Sanchez van Kammen, M., Aguiar de Sousa, D., Poli, S., Cordonnier, C., Heldner, M.R., Munckhof, A. van de, Krzywicka, K., Haaps, T. van, Ciccone, A., Middeldorp, S., Levi, M.M., Hovinga, J.A. Kremer, Silvis, S., Hiltunen, S., Mansour, M., Arauz, A., Barboza, M.A., Field, T.S., Tsivgoulis, G., Nagel, S., Lindgren, E., Tatlisumak, T., Jood, K., Putaala, J., Ferro, J.M., Arnold, M., Coutinho, J.M., Sharma, A.R., Elkady, A., Negro, A., Günther, A., Gutschalk, A., Schönenberger, S., Buture, A., Murphy, S., Nunes, A., Tiede, A., Philip, A. Puthuppallil, Mengel, A., Medina, A., Vogel, Å. Hellström, Tawa, A., Aujayeb, A., Casolla, B., Buck, B., Zanferrari, C., Garcia-Esperon, C., Vayne, C., Legault, C., Pfrepper, C., Tracol, C., Soriano, C., Guisado-Alonso, D., Bougon, D., Zimatore, D.S., Michalski, D., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Maistre, E. De, Carrera, E., Vuillier, F., Bonneville, F., Giammello, F., Bode, F.J., Zimmerman, J., d'Onofrio, F., Grillo, F., Cotton, F., Caparros, F., Puy, L., Maier, F., Gulli, G., Frisullo, G., Polkinghorne, G., Franchineau, G., Cangür, H., Katzberg, H., Sibon, I., Baharoglu, I., Brar, J., Payen, J.F., Burrow, J., Fernandes, J., Schouten, J., Althaus, K., Garambois, K., Derex, L., Humbertjean, L., Hernandez, L. Herrera, Kellermair, L., Martin, M, Petruzzellis, M., Cotelli, M., Dubois, M.C., Carvalho, M., Wittstock, M., Miranda, M., Skjelland, M., Poggio, M., et al. Bandettini di, Sanchez van Kammen, M., Aguiar de Sousa, D., Poli, S., Cordonnier, C., Heldner, M.R., Munckhof, A. van de, Krzywicka, K., Haaps, T. van, Ciccone, A., Middeldorp, S., Levi, M.M., Hovinga, J.A. Kremer, Silvis, S., Hiltunen, S., Mansour, M., Arauz, A., Barboza, M.A., Field, T.S., Tsivgoulis, G., Nagel, S., Lindgren, E., Tatlisumak, T., Jood, K., Putaala, J., Ferro, J.M., Arnold, M., Coutinho, J.M., Sharma, A.R., Elkady, A., Negro, A., Günther, A., Gutschalk, A., Schönenberger, S., Buture, A., Murphy, S., Nunes, A., Tiede, A., Philip, A. Puthuppallil, Mengel, A., Medina, A., Vogel, Å. Hellström, Tawa, A., Aujayeb, A., Casolla, B., Buck, B., Zanferrari, C., Garcia-Esperon, C., Vayne, C., Legault, C., Pfrepper, C., Tracol, C., Soriano, C., Guisado-Alonso, D., Bougon, D., Zimatore, D.S., Michalski, D., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Maistre, E. De, Carrera, E., Vuillier, F., Bonneville, F., Giammello, F., Bode, F.J., Zimmerman, J., d'Onofrio, F., Grillo, F., Cotton, F., Caparros, F., Puy, L., Maier, F., Gulli, G., Frisullo, G., Polkinghorne, G., Franchineau, G., Cangür, H., Katzberg, H., Sibon, I., Baharoglu, I., Brar, J., Payen, J.F., Burrow, J., Fernandes, J., Schouten, J., Althaus, K., Garambois, K., Derex, L., Humbertjean, L., Hernandez, L. Herrera, Kellermair, L., Martin, M, Petruzzellis, M., Cotelli, M., Dubois, M.C., Carvalho, M., Wittstock, M., Miranda, M., Skjelland, M., and Poggio, M., et al. Bandettini di
Abstract: Item does not contain fulltext, IMPORTANCE: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). OBJECTIVE: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. EXPOSURES: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. MAIN OUTCOMES AND MEASURES: Clinical characteristics and mortality rate. RESULTS: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.
Published: 2021

12. Characteristics and Outcomes of Patients with Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

Author: Sánchez Van Kammen, Mayte, Aguiar De Sousa, Diana, Poli, Sven, Cordonnier, Charlotte, Heldner, Mirjam R., Van De Munckhof, Anita, Krzywicka, Katarzyna, Van Haaps, Thijs, Ciccone, Alfonso, Middeldorp, Saskia, Levi, Marcel M., Kremer Hovinga, Johanna A., Silvis, Suzanne, Hiltunen, Sini, Mansour, Maryam, Arauz, Antonio, Barboza, Miguel A., Field, Thalia S., Tsivgoulis, Georgios, Nagel, Simon, Lindgren, Erik, Tatlisumak, Turgut, Jood, Katarina, Putaala, Jukka, Ferro, Jose M., Arnold, Marcel, Coutinho, Jonathan M., Sharma, Aarti R., Elkady, Ahmed, Negro, Alberto, Günther, Albrecht, Gutschalk, Alexander, Schönenberger, Silvia, Buture, Alina, Murphy, Sean, Paiva Nunes, Ana, Tiede, Andreas, Puthuppallil Philip, Anemon, Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Casolla, Barbara, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Pfrepper, Christian, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Zimatore, Domenico S., Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, De Maistre, Emmanuel, Carrera, Emmanuel, Vuillier, Fabrice, Bonneville, Fabrice, Giammello, Fabrizio, Bode, Felix J., Zimmerman, Julian, D'Onofrio, Florindo, Grillo, Francesco, Cotton, Francois, Caparros, François, Puy, Laurent, Maier, Frank, Gulli, Giosue, Frisullo, Giovanni, Polkinghorne, Gregory, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Brar, Jaskiran, Payen, Jean-François, Burrow, Jim, Fernandes, João, Schouten, Judith, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Kellermair, Lukas, Morin Martin, Mar, Petruzzellis, Marco, Cotelli, Maria, Dubois, Marie-Cécile, Carvalho, Marta, Wittstock, Matthias, Miranda, Miguel, Skjelland, Mona, Bandettini Di Poggio, Monica, Scholz, Moritz J., Raposo, Nicolas, Kahnis, Robert, Kruyt, Nyika, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Reiner, Peggy, Vieira, Ricardo, Acampora, Roberto, Kern, Rolf, Leker, Ronen, Coutts, Shelagh, Bal, Simerpreet, Sharma, Shyam S., Susen, Sophie, Cox, Thomas, Geeraerts, Thomas, Gattringer, Thomas, Bartsch, Thorsten, Kleinig, Timothy J., Dizonno, Vanessa, Arslan, Yildiz, Sánchez Van Kammen, Mayte, Aguiar De Sousa, Diana, Poli, Sven, Cordonnier, Charlotte, Heldner, Mirjam R., Van De Munckhof, Anita, Krzywicka, Katarzyna, Van Haaps, Thijs, Ciccone, Alfonso, Middeldorp, Saskia, Levi, Marcel M., Kremer Hovinga, Johanna A., Silvis, Suzanne, Hiltunen, Sini, Mansour, Maryam, Arauz, Antonio, Barboza, Miguel A., Field, Thalia S., Tsivgoulis, Georgios, Nagel, Simon, Lindgren, Erik, Tatlisumak, Turgut, Jood, Katarina, Putaala, Jukka, Ferro, Jose M., Arnold, Marcel, Coutinho, Jonathan M., Sharma, Aarti R., Elkady, Ahmed, Negro, Alberto, Günther, Albrecht, Gutschalk, Alexander, Schönenberger, Silvia, Buture, Alina, Murphy, Sean, Paiva Nunes, Ana, Tiede, Andreas, Puthuppallil Philip, Anemon, Mengel, Annerose, Medina, Antonio, Hellström Vogel, Åslög, Tawa, Audrey, Aujayeb, Avinash, Casolla, Barbara, Buck, Brian, Zanferrari, Carla, Garcia-Esperon, Carlos, Vayne, Caroline, Legault, Catherine, Pfrepper, Christian, Tracol, Clement, Soriano, Cristina, Guisado-Alonso, Daniel, Bougon, David, Zimatore, Domenico S., Michalski, Dominik, Blacquiere, Dylan, Johansson, Elias, Cuadrado-Godia, Elisa, De Maistre, Emmanuel, Carrera, Emmanuel, Vuillier, Fabrice, Bonneville, Fabrice, Giammello, Fabrizio, Bode, Felix J., Zimmerman, Julian, D'Onofrio, Florindo, Grillo, Francesco, Cotton, Francois, Caparros, François, Puy, Laurent, Maier, Frank, Gulli, Giosue, Frisullo, Giovanni, Polkinghorne, Gregory, Franchineau, Guillaume, Cangür, Hakan, Katzberg, Hans, Sibon, Igor, Baharoglu, Irem, Brar, Jaskiran, Payen, Jean-François, Burrow, Jim, Fernandes, João, Schouten, Judith, Althaus, Katharina, Garambois, Katia, Derex, Laurent, Humbertjean, Lisa, Lebrato Hernandez, Lucia, Kellermair, Lukas, Morin Martin, Mar, Petruzzellis, Marco, Cotelli, Maria, Dubois, Marie-Cécile, Carvalho, Marta, Wittstock, Matthias, Miranda, Miguel, Skjelland, Mona, Bandettini Di Poggio, Monica, Scholz, Moritz J., Raposo, Nicolas, Kahnis, Robert, Kruyt, Nyika, Huet, Olivier, Sharma, Pankaj, Candelaresi, Paolo, Reiner, Peggy, Vieira, Ricardo, Acampora, Roberto, Kern, Rolf, Leker, Ronen, Coutts, Shelagh, Bal, Simerpreet, Sharma, Shyam S., Susen, Sophie, Cox, Thomas, Geeraerts, Thomas, Gattringer, Thomas, Bartsch, Thorsten, Kleinig, Timothy J., Dizonno, Vanessa, and Arslan, Yildiz
Abstract: Importance: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). Objective: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. Design, Setting, and Participants: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. Exposures: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. Main Outcomes and Measures: Clinical characteristics and mortality rate. Results: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI
Published: 2021
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13. Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

Author: Sanchez van Kammen, M., Aguiar de Sousa, D., Poli, S., Cordonnier, C., Heldner, M.R., Munckhof, A. van de, Krzywicka, K., Haaps, T. van, Ciccone, A., Middeldorp, S., Levi, M.M., Hovinga, J.A. Kremer, Silvis, S., Hiltunen, S., Mansour, M., Arauz, A., Barboza, M.A., Field, T.S., Tsivgoulis, G., Nagel, S., Lindgren, E., Tatlisumak, T., Jood, K., Putaala, J., Ferro, J.M., Arnold, M., Coutinho, J.M., Sharma, A.R., Elkady, A., Negro, A., Günther, A., Gutschalk, A., Schönenberger, S., Buture, A., Murphy, S., Nunes, A., Tiede, A., Philip, A. Puthuppallil, Mengel, A., Medina, A., Vogel, Å. Hellström, Tawa, A., Aujayeb, A., Casolla, B., Buck, B., Zanferrari, C., Garcia-Esperon, C., Vayne, C., Legault, C., Pfrepper, C., Tracol, C., Soriano, C., Guisado-Alonso, D., Bougon, D., Zimatore, D.S., Michalski, D., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Maistre, E. De, Carrera, E., Vuillier, F., Bonneville, F., Giammello, F., Bode, F.J., Zimmerman, J., d'Onofrio, F., Grillo, F., Cotton, F., Caparros, F., Puy, L., Maier, F., Gulli, G., Frisullo, G., Polkinghorne, G., Franchineau, G., Cangür, H., Katzberg, H., Sibon, I., Baharoglu, I., Brar, J., Payen, J.F., Burrow, J., Fernandes, J., Schouten, J., Althaus, K., Garambois, K., Derex, L., Humbertjean, L., Hernandez, L. Herrera, Kellermair, L., Martin, M, Petruzzellis, M., Cotelli, M., Dubois, M.C., Carvalho, M., Wittstock, M., Miranda, M., Skjelland, M., Poggio, M., et al. Bandettini di, Sanchez van Kammen, M., Aguiar de Sousa, D., Poli, S., Cordonnier, C., Heldner, M.R., Munckhof, A. van de, Krzywicka, K., Haaps, T. van, Ciccone, A., Middeldorp, S., Levi, M.M., Hovinga, J.A. Kremer, Silvis, S., Hiltunen, S., Mansour, M., Arauz, A., Barboza, M.A., Field, T.S., Tsivgoulis, G., Nagel, S., Lindgren, E., Tatlisumak, T., Jood, K., Putaala, J., Ferro, J.M., Arnold, M., Coutinho, J.M., Sharma, A.R., Elkady, A., Negro, A., Günther, A., Gutschalk, A., Schönenberger, S., Buture, A., Murphy, S., Nunes, A., Tiede, A., Philip, A. Puthuppallil, Mengel, A., Medina, A., Vogel, Å. Hellström, Tawa, A., Aujayeb, A., Casolla, B., Buck, B., Zanferrari, C., Garcia-Esperon, C., Vayne, C., Legault, C., Pfrepper, C., Tracol, C., Soriano, C., Guisado-Alonso, D., Bougon, D., Zimatore, D.S., Michalski, D., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Maistre, E. De, Carrera, E., Vuillier, F., Bonneville, F., Giammello, F., Bode, F.J., Zimmerman, J., d'Onofrio, F., Grillo, F., Cotton, F., Caparros, F., Puy, L., Maier, F., Gulli, G., Frisullo, G., Polkinghorne, G., Franchineau, G., Cangür, H., Katzberg, H., Sibon, I., Baharoglu, I., Brar, J., Payen, J.F., Burrow, J., Fernandes, J., Schouten, J., Althaus, K., Garambois, K., Derex, L., Humbertjean, L., Hernandez, L. Herrera, Kellermair, L., Martin, M, Petruzzellis, M., Cotelli, M., Dubois, M.C., Carvalho, M., Wittstock, M., Miranda, M., Skjelland, M., and Poggio, M., et al. Bandettini di
Abstract: Contains fulltext : 245661.pdf (Publisher’s version ) (Closed access), IMPORTANCE: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). OBJECTIVE: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. EXPOSURES: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. MAIN OUTCOMES AND MEASURES: Clinical characteristics and mortality rate. RESULTS: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.
Published: 2021

14. Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

Author: Sanchez van Kammen, M., Aguiar de Sousa, D., Poli, S., Cordonnier, C., Heldner, M.R., Munckhof, A. van de, Krzywicka, K., Haaps, T. van, Ciccone, A., Middeldorp, S., Levi, M.M., Hovinga, J.A. Kremer, Silvis, S., Hiltunen, S., Mansour, M., Arauz, A., Barboza, M.A., Field, T.S., Tsivgoulis, G., Nagel, S., Lindgren, E., Tatlisumak, T., Jood, K., Putaala, J., Ferro, J.M., Arnold, M., Coutinho, J.M., Sharma, A.R., Elkady, A., Negro, A., Günther, A., Gutschalk, A., Schönenberger, S., Buture, A., Murphy, S., Nunes, A., Tiede, A., Philip, A. Puthuppallil, Mengel, A., Medina, A., Vogel, Å. Hellström, Tawa, A., Aujayeb, A., Casolla, B., Buck, B., Zanferrari, C., Garcia-Esperon, C., Vayne, C., Legault, C., Pfrepper, C., Tracol, C., Soriano, C., Guisado-Alonso, D., Bougon, D., Zimatore, D.S., Michalski, D., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Maistre, E. De, Carrera, E., Vuillier, F., Bonneville, F., Giammello, F., Bode, F.J., Zimmerman, J., d'Onofrio, F., Grillo, F., Cotton, F., Caparros, F., Puy, L., Maier, F., Gulli, G., Frisullo, G., Polkinghorne, G., Franchineau, G., Cangür, H., Katzberg, H., Sibon, I., Baharoglu, I., Brar, J., Payen, J.F., Burrow, J., Fernandes, J., Schouten, J., Althaus, K., Garambois, K., Derex, L., Humbertjean, L., Hernandez, L. Herrera, Kellermair, L., Martin, M, Petruzzellis, M., Cotelli, M., Dubois, M.C., Carvalho, M., Wittstock, M., Miranda, M., Skjelland, M., Poggio, M., et al. Bandettini di, Sanchez van Kammen, M., Aguiar de Sousa, D., Poli, S., Cordonnier, C., Heldner, M.R., Munckhof, A. van de, Krzywicka, K., Haaps, T. van, Ciccone, A., Middeldorp, S., Levi, M.M., Hovinga, J.A. Kremer, Silvis, S., Hiltunen, S., Mansour, M., Arauz, A., Barboza, M.A., Field, T.S., Tsivgoulis, G., Nagel, S., Lindgren, E., Tatlisumak, T., Jood, K., Putaala, J., Ferro, J.M., Arnold, M., Coutinho, J.M., Sharma, A.R., Elkady, A., Negro, A., Günther, A., Gutschalk, A., Schönenberger, S., Buture, A., Murphy, S., Nunes, A., Tiede, A., Philip, A. Puthuppallil, Mengel, A., Medina, A., Vogel, Å. Hellström, Tawa, A., Aujayeb, A., Casolla, B., Buck, B., Zanferrari, C., Garcia-Esperon, C., Vayne, C., Legault, C., Pfrepper, C., Tracol, C., Soriano, C., Guisado-Alonso, D., Bougon, D., Zimatore, D.S., Michalski, D., Blacquiere, D., Johansson, E., Cuadrado-Godia, E., Maistre, E. De, Carrera, E., Vuillier, F., Bonneville, F., Giammello, F., Bode, F.J., Zimmerman, J., d'Onofrio, F., Grillo, F., Cotton, F., Caparros, F., Puy, L., Maier, F., Gulli, G., Frisullo, G., Polkinghorne, G., Franchineau, G., Cangür, H., Katzberg, H., Sibon, I., Baharoglu, I., Brar, J., Payen, J.F., Burrow, J., Fernandes, J., Schouten, J., Althaus, K., Garambois, K., Derex, L., Humbertjean, L., Hernandez, L. Herrera, Kellermair, L., Martin, M, Petruzzellis, M., Cotelli, M., Dubois, M.C., Carvalho, M., Wittstock, M., Miranda, M., Skjelland, M., and Poggio, M., et al. Bandettini di
Abstract: Contains fulltext : 245661.pdf (Publisher’s version ) (Closed access), IMPORTANCE: Thrombosis with thrombocytopenia syndrome (TTS) has been reported after vaccination with the SARS-CoV-2 vaccines ChAdOx1 nCov-19 (Oxford-AstraZeneca) and Ad26.COV2.S (Janssen/Johnson & Johnson). OBJECTIVE: To describe the clinical characteristics and outcome of patients with cerebral venous sinus thrombosis (CVST) after SARS-CoV-2 vaccination with and without TTS. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data from an international registry of consecutive patients with CVST within 28 days of SARS-CoV-2 vaccination included between March 29 and June 18, 2021, from 81 hospitals in 19 countries. For reference, data from patients with CVST between 2015 and 2018 were derived from an existing international registry. Clinical characteristics and mortality rate were described for adults with (1) CVST in the setting of SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia, (2) CVST after SARS-CoV-2 vaccination not fulling criteria for TTS, and (3) CVST unrelated to SARS-CoV-2 vaccination. EXPOSURES: Patients were classified as having TTS if they had new-onset thrombocytopenia without recent exposure to heparin, in accordance with the Brighton Collaboration interim criteria. MAIN OUTCOMES AND MEASURES: Clinical characteristics and mortality rate. RESULTS: Of 116 patients with postvaccination CVST, 78 (67.2%) had TTS, of whom 76 had been vaccinated with ChAdOx1 nCov-19; 38 (32.8%) had no indication of TTS. The control group included 207 patients with CVST before the COVID-19 pandemic. A total of 63 of 78 (81%), 30 of 38 (79%), and 145 of 207 (70.0%) patients, respectively, were female, and the mean (SD) age was 45 (14), 55 (20), and 42 (16) years, respectively. Concomitant thromboembolism occurred in 25 of 70 patients (36%) in the TTS group, 2 of 35 (6%) in the no TTS group, and 10 of 206 (4.9%) in the control group, and in-hospital mortality rates were 47% (36 of 76; 95% CI, 37-58), 5% (2 of 37; 95% CI, 1-18), and 3.9% (8 of 207; 95% CI, 2.
Published: 2021

15. Images depicting headache pain – a tool to aid the diagnosis of cluster headache: a pilot study

Author: Buture,Alina, Boland,Jason W, Ahmed,Fayyaz, Dikomitis,Lisa, Buture,Alina, Boland,Jason W, Ahmed,Fayyaz, and Dikomitis,Lisa
Abstract: Alina Buture,1 Jason W Boland,2 Fayyaz Ahmed,1,3 Lisa Dikomitis4,51Hull York Medical School, University of Hull, Hull, UK; 2Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK; 3Department of Neurology, Hull Royal Infirmary, Hull, UK; 4School of Medicine, Keele University, Newcastle-under-Lyme, UK; 5School of Primary, Community and Social Care, Keele University, Newcastle-under-Lyme, UKCorrespondence: Alina ButureHull York Medical School, University of Hull, Cottingham Road, Hull HU6 7RX, UKTel +44 745 987 2950Email hyab20@hyms.ac.ukIntroduction and objective: The diagnosis of primary headaches is based on the International Classification of Headache Disorders (ICHD-3). Cluster headache (CH), a debilitating primary headache, is often misdiagnosed as migraine. In the absence of biological markers, a new visual screening tool with images depicting pain could aid the correct diagnosis of CH. The objective of the study is to test the tool on healthy participants and participants with CH and migraine.Methods: In phase 1, 6 images portraying people with pain were tested on 150 healthy participants. The healthy participants were asked to rate the images as mild, moderate, severe or excruciating pain. In phase 2, the images were further tested on 116 participants with headache (16 participants with CH, 100 participants with migraine). The participants were recruited prospectively from a tertiary headache center between February and May 2017. The participants were asked to choose which image best illustrated their headache attacks.Results: Phase 1 results showed that the images represent a range of headache pain severities from mild to excruciating as rated by healthy participants. They rated two images as excruciating, one image as severe, one image as moderate/severe, one image as moderate and one image as mild. Phase 2 results showed that two-thirds of participants with CH (69%) and half of the participants with migraine (52%) c
Published: 2019

16. Update on the pathophysiology of cluster headache: imaging and neuropeptide studies

Author: Buture,Alina, Boland,Jason W, Dikomitis,Lisa, Ahmed,Fayyaz, Buture,Alina, Boland,Jason W, Dikomitis,Lisa, and Ahmed,Fayyaz
Abstract: Alina Buture,1,2 Jason W Boland,2 Lisa Dikomitis,3 Fayyaz Ahmed1,2 1Department of Neurology, Hull Royal Infirmary, Hull, UK; 2Hull York Medical School, University of Hull, Hull, UK; 3School of Medicine and Institute of Primary Care and Health Sciences, Keele University, Newcastle, UK Objective: Cluster headache (CH) is the most severe primary headache condition. Its pathophysiology is multifaceted and incompletely understood. This review brings together the latest neuroimaging and neuropeptide evidence on the pathophysiology of CH.Methods: A review of the literature was conducted by searching PubMed and Web of Science. The search was conducted using the following keywords: imaging studies, voxel-based morphometry, diffusion-tensor imaging, diffusion magnetic resonance imaging, tractography, connectivity, cerebral networks, neuromodulation, central modulation, deep brain stimulation, orexin-A, orexin-B, tract-based spatial statistics, single-photon emission computer tomography studies, positron-emission tomography, functional magnetic resonance imaging, magnetic resonance spectroscopy, trigeminovascular system, neuropeptides, calcitonin gene-related peptide, neurokinin A, substance P, nitric oxide synthase, pituitary adenylate cyclase-activating peptide, vasoactive intestinal peptide, neuropeptide Y, acetylcholine, noradrenaline, and ATP. “Cluster headache” was combined with each keyword for more relevant results. All irrelevant and duplicated records were excluded. Search dates were from October 1976 to May 2018.Results: Neuroimaging studies support the role of the hypothalamus in CH, as well as other brain areas involved in the pain matrix. Activation of the trigeminovascular system and the release of neuropeptides play an important role in CH pathophysiology. Among neuropeptides, calcitonin gene-related peptide, vasoactive intestinal peptide, and pituitary adenylate cyclase-activating peptide have been reported to be reliable biomarkers for CH
Published: 2019

17. Iatrogenic visual aura: a case report and a brief review of the literature

Author: Buture,Alina, Khalil,Modar, Ahmed,Fayyaz, Buture,Alina, Khalil,Modar, and Ahmed,Fayyaz
Abstract: Alina Buture, Modar Khalil, Fayyaz Ahmed Neurology Department, Hull Royal Infirmary, Hull, UK Abstract: Iatrogenic migraine aura following transseptal catheterization has only rarely been reported in the literature. We report the case of a 60-year-old female who presented with new onset of migraine with visual aura 1 day after transseptal cryoballoon catheter ablation for atrial fibrillation. The patient had a 5-year history of typical migraine without aura and had never experienced visual aura before the cardiac intervention. The neurological examination, fundoscopy, and blood tests were normal. The magnetic resonance imaging of the brain showed small vessel ischemia without evidence of vessel ischemic changes in the occipital lobes and large blood vessel disease. A change in the characteristics of existing migraine could occur following an iatrogenic episode, which in this case was catheter ablation for atrial fibrillation. A new onset of aura is considered an indication for a brain scan as it may signify underlying new pathology. Keywords: migraine aura, iatrogenic, transseptal catheterization
Published: 2017

18. Evidence-based treatments for cluster headache

Author: Gooriah,Rubesh, Buture,Alina, Ahmed,Fayyaz, Gooriah,Rubesh, Buture,Alina, and Ahmed,Fayyaz
Abstract: Rubesh Gooriah, Alina Buture, Fayyaz Ahmed Department of Neurology, Hull Royal Infirmary, Kingston upon Hull, UK Abstract: Cluster headache (CH), one of the most painful syndromes known to man, is managed with acute and preventive medications. The brief duration and severity of the attacks command the use of rapid-acting pain relievers. Inhalation of oxygen and subcutaneous sumatriptan are the two most effective acute therapeutic options for sufferers of CH. Several preventive medications are available, the most effective of which is verapamil. However, most of these agents are not backed by strong clinical evidence. In some patients, these options can be ineffective, especially in those who develop chronic CH. Surgical procedures for the chronic refractory form of the disorder should then be contemplated, the most promising of which is hypothalamic deep brain stimulation. We hereby review the pathogenesis of CH and the evidence behind the treatment options for this debilitating condition. Keywords: cluster headache, pathogenesis, vasoactive intestinal peptide, suprachiasmatic nucleus
Published: 2015

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18 results on '"Buture A"'

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

2. Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries

3. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

4. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

5. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

6. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

7. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

8. Management of Cerebral Venous Thrombosis Due to Adenoviral COVID-19 Vaccination

9. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

10. Management of cerebral venous thrombosis due to adenoviral covid-19 vaccination

11. Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

12. Characteristics and Outcomes of Patients with Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

13. Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

14. Characteristics and Outcomes of Patients With Cerebral Venous Sinus Thrombosis in SARS-CoV-2 Vaccine-Induced Immune Thrombotic Thrombocytopenia

15. Images depicting headache pain – a tool to aid the diagnosis of cluster headache: a pilot study

16. Update on the pathophysiology of cluster headache: imaging and neuropeptide studies

17. Iatrogenic visual aura: a case report and a brief review of the literature

18. Evidence-based treatments for cluster headache

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