Abstract
CEREBRAL VENOUS SINUS THROMBOSIS (CVST) FOLLOWING COVID-19 VACCINATION: A SYSTEMATIC REVIEW OF RECENT EVIDENCE

Soji Akin Ojo*, Anigbo Chinyere, Benish Alam, Hira Tahir, Joshua O Olajide, Olamide Adefashola, Ayodele Paul Ogunro, Anum Umer, Agboola Adesola Ahmed, Patrick Batti, Joy O Iroro, Osemwegie Oswald Ugbo, Yishwerer Karadapanddy, Sidra Shahid Mubasher, Blessing OJinna

ABSTRACT

Background: With 4.45 billion people vaccinated against COVID-19 so far, it is imperative to note the correlation of COVID-19 Vaccination with a rare neurological disorder – cerebral venous sinus thrombosis (CVST) in current literature. This study aims to synthesize the clinical, managerial, and death outcomes of CVST post-COVID-19 vaccination. Methods: As per the PRISMA Statement 2020 guidelines, case series and cohorts that comprised of confirmed CVST patients were included. A systematic search across PubMed, Cochrane Central, and EMBASE were conducted through March 10, 2022, with keywords including COVID-19, SARS-CoV-2, CVST, Cerebral, Venous, Sinus, Thrombosis, Thrombotic, TTS, VITT. The findings were tabulated, quantified, and subsequently presented. EndNote X9 was used to store the bibliographic entries and SPSS was utilized for statistical analysis. Cohen's Coefficient of Agreement was also computed for inter-reviewer agreement. Results: In total, 9 studies were included in the review totaling 8,131,391 participants. There was a total of 4,397,516 females (54.1%). The mean age was 47.4 years. The mean days between vaccination and presentation was 8 for all included studies. Among CVST patients (N=777), 197 of them did not survive (25.4%). The inter-reliability score was strong (0.83). Conclusion: While COVID-19 vaccine-caused CVST is prone to any age group and gender, this study finds that women in the age group of 30-49 are at a higher risk. Both mRNA and adenoviral vaccines may lead to CVST. While the disease has a high mortality, a timely diagnosis may protect from adverse outcomes among the patient group. It is evident that a high degree of caution is required with at-risk groups by healthcare providers, but excessive concern among the general public may be unwarranted. While this study sets the groundwork to establish the correlation between CVST and mortality, further studies are required to truly compute the causality between the COVID-19 vaccine and CVST.

Keywords: COVID-19; COVID-19 vaccine; CVST; cerebral venous sinus thrombosis; vaccine.


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