BACKGROUND AND PURPOSE: Recent studies suggested an increased incidence of cerebral venous thrombosis (CVT) during the coronavirus disease 2019 (COVID-19) pandemic. We evaluated the volume of CVT hospitalization and in-hospital mortality during the 1st year of the COVID-19 pandemic compared to the preceding year. METHODS: We conducted a cross-sectional retrospective study of 171 stroke centers from 49 countries. We recorded COVID-19 admission volumes, CVT hospitalization, and CVT in-hospital mortality from January 1, 2019, to May 31, 2021. CVT diagnoses were identified by International Classification of Disease-10 (ICD-10) codes or stroke databases. We additionally sought to compare the same metrics in the first 5 months of 2021 compared to the corresponding months in 2019 and 2020 (ClinicalTrials.gov Identifier: NCT04934020). RESULTS: There were 2,313 CVT admissions across the 1-year pre-pandemic (2019) and pandemic year (2020); no differences in CVT volume or CVT mortality were observed. During the first 5 months of 2021, there was an increase in CVT volumes compared to 2019 (27.5%; 95% confidence interval [CI], 24.2 to 32.0; P<0.0001) and 2020 (41.4%; 95% CI, 37.0 to 46.0; P<0.0001). A COVID-19 diagnosis was present in 7.6% (132/1,738) of CVT hospitalizations. CVT was present in 0.04% (103/292,080) of COVID-19 hospitalizations. During the first pandemic year, CVT mortality was higher in patients who were COVID positive compared to COVID negative patients (8/53 [15.0%] vs. 41/910 [4.5%], P=0.004). There was an increase in CVT mortality during the first 5 months of pandemic years 2020 and 2021 compared to the first 5 months of the pre-pandemic year 2019 (2019 vs. 2020: 2.26% vs. 4.74%, P=0.05; 2019 vs. 2021: 2.26% vs. 4.99%, P=0.03). In the first 5 months of 2021, there were 26 cases of vaccine-induced immune thrombotic thrombocytopenia (VITT), resulting in six deaths. CONCLUSIONS: During the 1st year of the COVID-19 pandemic, CVT hospitalization volume and CVT in-hospital mortality did not change compared to the prior year. COVID-19 diagnosis was associated with higher CVT in-hospital mortality. During the first 5 months of 2021, there was an increase in CVT hospitalization volume and increase in CVT-related mortality, partially attributable to VITT.

1st Department of Neurology Institute of Psychiatry and Neurology Warsaw Poland

2nd Department of Neurology AHEPA University Hospital Aristotle University of Thessaloniki School of Medicine Faculty of Health Sciences Thessaloniki Greece

2nd Department of Neurology Attikon University Hospital National and Kapodistrian University of Athens Athens Greece

2nd Department of Neurology Institute of Psychiatry and Neurology Warsaw Poland

Advanced Brain Research Tokushima University Tokushima Japan

Amita Health and University of Illinois Chicago Chicago United States

Bach Mai Hospital Hanoi Vietnam

Baptist Health Medical Center Little Rock Little Rock United States

Baptist Health Medical Group Baptist Health Lexington Lexington United States

Bordeaux University Hospital Neurology Stroke Unit Bordeaux France

Bucharest University Emergency Hospital Bucharest Romania

Central Military Hospital Prague Prague Czech Republic

Central Stroke Unit Neuroscience Directorate Khoula Hospital Ministry of Health Muscat Oman

Centre Hospitalier de l'Université de Bordeaux INSERM Bordeaux Population Health Research Center CIC EC 14 01 Bordeaux France

Centro Hospitalar Universitário de São João Porto Portugal

Cerebrovascular Medicine Stroke Center Saga Medical Centre Koseikan Saga Japan

Cleveland Clinic Abu Dhabi Abu Dhabi United Arabe Emirates

Clinic of Neurology Military Institute of Medicine Szasero 128 Warsaw Poland

Clinic of Neurology Military Institute of Medicine Warsaw Poland

Community Memorial Hospital Ventura United States

Complejo Hospitalario Universitario de Albacete Albacete Spain

Comprehensive Stroke Center Hospital Clínic de Barcelona Barcelona Spain

Copenhagen University Hospital Copenhagen Denmark

County Emergency Clinic Hospital Brasov Brasov Romania

Da Nang Hospital Da Nang Vietnam

Dartmouth Hitchcock Medical Center Lebanon United States

Departamento de Neurología Hospital Nacional Edgardo Rebagliati Martins Essalud Lima Peru

Department of Cerebrovascular Medicine National Cerebral and Cardiovascular Center Osaka Japan

Department of Diagnostic Radiology Halifax Infirmary Dalhousie University Halifax Canada

Department of Endovascular Surgery Tokyo Medical and Dental University Tokyo Japan

Department of General Practice University of Oslo

Department of Medical Records Federal Medical Centre Owo Nigeria

Department of Medicine Federal Medical Centre Owerri Neurology Unit Federal Medical Centre Owerri Nigeria

Department of Medicine National University of Malaysia Kuala Lumpur Malaysia

Department of Medicine Pusat Perubatan Universiti Kebangsaan Malaysia Kuala Lumpur Malaysia

Department of Medicine University of Otago

Department of Neurology Ajou University Hospital Ajou South Korea

Department of Neurology Akershus University Hospital University of Oslo Lørenskog Norway

Department of Neurology Albertinen Krankenhaus Hamburg Germany

Department of Neurology Alexandria University Alexandria Egypt

Department of Neurology and Centre of Clinical Neuroscience 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czech Republic

Department of Neurology and Division of Neuroradiology Vascular and Interventional Radiology Medical University of Graz Graz Austria

Department of Neurology and Interventional Neuroradiology Hospital de Base de São José do Rio Preto São Paulo Brazil

Department of Neurology and Neurosurgery Vidant Medical Center Greenville United States

Department of Neurology and Stroke Eberhard Karls University Tuebingen Germany

Department of Neurology Blansko Hospital Czech Republic Blansko Czech Republic

Department of Neurology Boston Medical Center Boston University School of Medicine Boston MA USA

Department of Neurology Central Clinical Hospital of the Ministry of Interior and Administration Warsaw Poland

Department of Neurology Central Clinical Hospital of the Ministry of Internal Affairs and Administration Warsaw Poland

Department of Neurology Centro Hospitalar Universitário de São João Porto Portugal

Department of Neurology Christchurch Hospital Christchurch New Zealand

Department of Neurology Comprehensive Stroke Center Charles University Faculty of Medicine and University Hospital Hradec Kralove Czech Republic

Department of Neurology Cooper Neurological Institute Cooper University Hospital Camden USA

Department of Neurology Cooper University Camden NJ USA

Department of Neurology County Clinic Hospital Faculty of Medicine Transilvania University Brasov Romania

Department of Neurology Department of Radiology and Nuclear Medicine Erasmus MC University Medical Center Rotterdam Rotterdam Netherlands

Department of Neurology Egas Moniz Hospital West Lisbon Hospital Center Lisbon Portugal

Department of Neurology Emory University School of Medicine Atlanta United States

Department of Neurology Erasmus MC University Medical Center Rotterdam Rotterdam Netherlands

Department of Neurology Faculty Hospital Ostrava Ostrava Czech Republic

Department of Neurology Faculty Hospital Trnava Trnava Slovakia

Department of Neurology Foshan Sanshui District People's Hospital Foshan China

Department of Neurology General Hospital of Northern Theater Command Shen Yang China

Department of Neurology Grady Memorial Hospital Emory University School of Medicine Atlanta United States

Department of Neurology Grant Medical College and Sir JJ Hospital Mumbai India

Department of Neurology Heidelberg University Hospital Heidelberg Germany

Department of Neurology Helsinki University Hospital and University of Helsinki Helsinki Finland

Department of Neurology Henry Ford Health System Detroit Michigan USA

Department of Neurology Henry Ford Health System Detroit United States

Department of Neurology Hospital de especialidades del Centro Médico Nacional Siglo XXI IMSS Mexico City Mexico

Department of Neurology Hospital de Santa Maria North Lisbon University Hospital Center Lisbon Portugal

Department of Neurology Hospital Garcia de Orta Almada Portugal

Department of Neurology Hospital Jihlava Jihlava Czech Republic

Department of Neurology Hospital Universitario Ramón y Cajal Madrid Spain

Department of Neurology Hospital Universitario Rey Juan Carlos Madrid Spain

Department of Neurology Hospital Universitario Virgen Macarena Seville Spain

Department of Neurology in Sandomierz Collegium Medicum Jan Kochanowski University in Kielce Sandomierz Poland

Department of Neurology Institute of Medical Sciences Medical College of Rzeszow University Rzeszow Poland

Department of Neurology International Clinical Research Center St Anne's University Hospital and Faculty of Medicine Masaryk University Brno Czech Republic

Department of Neurology Japanese Red Cross Kumamoto Hospital Kumamoto Japan

Department of Neurology Japanese Red Cross Matsue Hospital Matsue Japan

Department of Neurology Kangbuk Samsung Hospital Sungkyunkwan University School of Medicine Seoul South Korea

Department of Neurology Keimyung University Dongsan Hospital Keimyung University School of Medicine Daegu South Korea

Department of Neurology King Fahad Hospital of the University Imam Abdulrahman bin Faisal University Dammam Dammam Saudi Arabia

Department of Neurology Klinikum Ludwigshafen Ludwigshafen Rhein Germany

Department of Neurology Kobe City Medical Center General Hospital Kobe City Japan

Department of Neurology Krajská zdravotní Hospital Chomutov Chomutov Czech Republic

Department of Neurology Lahey Health Burlington United States

Department of Neurology Leszek Giec Upper Silesian Medical Centre of the Silesian Medical University in Katowice School of Health Sciences Medical University of Silesia in Katowice Katowice Poland

Department of Neurology Masaryk University Faculty of Medicine University Hospital Brno Brno Czech Republic

Department of Neurology Medical University of Graz Graz Austria

Department of Neurology National Cerebral and Cardiovascular Center Osaka Japan

Department of Neurology National Health Insurance Service Ilsan Hospital Goyang South Korea

Department of Neurology Osaka General Medical Center Osaka Japan

Department of Neurology Pediatrics Emory University Atlanta United States

Department of Neurology Rhode Island Hospital Brown University Providence RI USA

Department of Neurology Rothschild Foundation Hospital Paris France

Department of Neurology Saiseikai Fukuoka General Hospital Fukuoka Japan

Department of Neurology Sestre Milosrdnice University Hospital Center Croatia Zagreb Croatia

Department of Neurology Sir Salimullah Medical College Mitford Dhaka Bangladesh

Department of Neurology Slovak Medical University Bratislava Slovakia

Department of Neurology Specialist Hospital Konskie Collegium Medicum Jan Kochanowski University Kielce Poland

Department of Neurology St George's University Hospital London UK

Department of Neurology St Jadwiga Provincial Specialist Hospital in Opole Institute of Medical Sciences University of Opole Opole Poland

Department of Neurology SUNY Upstate Syracuse United States

Department of Neurology Texas Tech University Health Science Center El Paso United States

Department of Neurology The Jikei University School of Medicine Tokyo Japan

Department of Neurology Uijeongbu St Mary's Hospital College of Medicine The Catholic University of Korea Uijeongbu South Korea

Department of Neurology Universitair Ziekenhuis Brussel Center for Neurosciences Vrije Universiteit Brussel Brussels Belgium

Department of Neurology University Hospital Plzen Plzen Czech Republic

Department of Neurology University Hospitals Antwerp Antwerp Belgium

Department of Neurology University Hospitals of Geneva Geneva Switzerland

Department of Neurology University of Arkansas for Medical Sciences Little Rock United States

Department of Neurology University of Colorado School of Medicine Aurora CO USA

Department of Neurology University of Florida Gainesville United States

Department of Neurology University of Kansas Medical Center Kansas City United States

Department of Neurology University of Pittsburgh Medical Center Pittsburgh PA USA

Department of Neurology University of Tennessee Health Science Center Memphis TN USA

Department of Neurology Vali e Asr Hospital School of Medicine Zanjan University of Medical Sciences Zanjan Iran

Department of Neurology Wake Forest Baptist Medical Center Winston Salem United States

Department of Neuroradiology Hospital Universitario Rey Juan Carlos Madrid Spain

Department of Neurosciences and Comprehensive Stroke Center Spectrum Health and Michigan State University College of Human Medicine Grand Rapids United States

Department of Neurosciences Lausanne University Hospital Lausanne Switzerland

Department of Neurosurgery Kobe City Medical Center General Hospital Kobe Japan

Department of Neurosurgery University of Texas Medical Branch Galveston United States

Department of Radiation Oncology Boston Medical Center Boston University School of Medicine Boston MA USA

Department of Radiology Boston Medical Center Boston University School of Medicine Boston MA USA

Department of Radiology Siriraj Hospital Mahidol University Bangkok Thailand

Department of Radiology University of Texas Medical Branch Galveston United States

Department of Stroke and Cerebrovascular Diseases University of Tsukuba Hospital Tskukuba Japan

Department of Stroke Medicine Charing Cross Hospital Imperial College Healthcare NHS Trust London UK

Department of Stroke Neurology Kohnan Hospital Sendai Japan

Department of Stroke Neurology National Hospital Organization Osaka National Hospital Osaka Japan

Department of Translational Neuroscience University of Antwerp Belgium

Department of Urgent Neurology University Clinic of Neurology University Ss Cyril and Methodius Faculty of Medicine Skopje North Macedonia

Division de Neurologia Vascular Departmento de Neurologia Institute for Neurological Research FLENI Buenos Aires Argentina

Division of Neurology Dept Medicine University of British Columbia Vancouver BC Canada

Dr Soetomo General Hospital Surabaya Universitas Airlangga Surabaya Indonesia

El hussein Alzahar University Hospital Cairo Egypt

Eskisehir Osmangazi University Eskisehir Turkey

Geneva

Hertie Institute for Clinical Brain Research Eberhard Karls University Tuebingen Germany

Hillel Yaffe Medical Center Hadera Israel

Hopital Erasme Brussels Belgium

Hospital das Clínicas São Paulo University São Paulo Brazil

Hospital de Base do Distrito Federal Brasilia Brazil

Hospital de Santa Maria Centro Hospitalar Lisboa Norte Lisbon Portugal

Hospital de Santa Maria Centro Hospitalar Lisboa Norte Portugal

Hospital General San Juan de Dios Guatemala City Guatemala

Hospital São Carlos Brazil Fortaleza Brazil

Hospital Sultan Abdul Halim Sungai Petani Malaysia

Hospital Universitario rey Juan Carlos Spain

HSHS St John's Hospital Southern Illinois University School of Medicine Springfield United States

Hue Central Hue Vietnam

Interventional Neuroradiology Hospital Clinic de Barcelona Barcelona Spain

Interventional Neuroradiology University Hospitals of Geneva Geneva Switzerland

Interventional Neurovascular Unit Careggi University Hospital Florence Italy

IRCCS Istituto delle Scienze Neurologiche di Bologna Neurologia e Rete Stroke Metropolitana Bologna Italy

Istanbul Aydın University Florya Medicalpark Stroke Center Istanbul Turkey

Jessenius Medical Faculty Martin Commenius University Bratislava Slovakia

Karvina Mining Hospital Czech Republic Karvina Czech Republic

Lahore General Hospital Lahore Pakistan

Lariboisiere Hospital Paris France

Loyola University Chicago Stritch School of Medicine Maywood United States

Mazumdar Shaw Medical Center Bangalore India

Miami Cardiac and Vascular Institute Miami Neuroscience Institute Miami United States

Miami Neuroscience Institute Miami United States

Moinhos de Vento Hospital Brazil Porto Alegre Brazil

Municipal Hospital Ostrava Ostrava Czech Republic

Na Homolce Hospital Prague Czech Republic

Neurocenter Cantonal Hospital of Lucerne Lucerne Switzerland

Neurocenter Regional Hospital Liberec Liberec Czech Republic

Neurological Department Alessandro Manzoni Hospital ASST Lecco Via dell'Eremo 9 11 Lecco Italy

Neurology and Stroke Unit Department of Neuroscience Bufalini Hospital Cesena Italy

Neurology and Stroke Unit Ospedale Bufalini Cesena Italy

Neurology Boston Medical Center Boston USA

Neurology České Budejovice Hospital České Budějovice Czech Republic

Neurology Department Centro Hospitalar Vila Nova de Gaia Espinho Vila Nova de Gaia Portugal

Neurology Department Hillel Yaffe Medical Center Hadera Israel

Neurology Department Leuven University Hospital Leuven Belgium

Neurology Hospital Příbram Příbram Czech Republic

Neurology Hospital Vyskov Vyskov Czech Republic

Neurology McGovern Medical School at the University of Texas Health Science Center Houston United States

Neurology Unit University of Ilorin Ilorin Nigeria

Neuroradiology Department Centro Hospitalar de Vila Nova de Gaia Espinho Vila Nova de Gaia Portugal

Neuroradiology Nottingham University Hospitals NHS Trust Nottingham United Kingdom

Neuroscience and Stroke Program Bon Secours Mercy Health St Vincent Hospital Toledo United States

Neuroscience Section Department of Biotechnological and Applied Clinical Sciences University of L'Aquila L'Aquila Italy

Neurosciences Research Center Imam Reza Hospital Tabriz University of Medical Sciences Tabriz Iran

Neurosciences Research Center Razi Hospital Tabriz University of Medical Sciences Tabriz Iran

Neurosciences Research Center Tabriz University of Medical Sciences Tabriz Iran

Neurovascular Research Laboratory Instituto de Biomedicina de Sevilla IbiS Spain

Neurovascular Unit and Neurology Department University Hospital Jose Eleuterio Gonzalez Universidad Autonoma de Nuevo Leon Monterrey Mexico

Oblastní nemocnice Trutnov a s Trutnov Czech Republic

Ohio Health Riverside Methodist Hospital Columbus United States

Osaka Red Cross Hospital Osaka Japan

Raffles Hospital Singapore Singapore

Regional Hospital Karlovy Vary Karlovy Vary Czech Republic

Riverside Regional Medical Center Newport News United States

Royal North Shore Hospital Sydney Australia

Royal University Hospital Saskatoon Canada

Rush University Medical Center Chicago United States

Santa Barbara Cottage Hospital Santa Barbara United States

Shiroyama Hospital Shiroyama Japan

Sree Chitra Tirunal Institute for Medical Sciences and Technology Kerala India

St Anna University Hospital Sofia Bulgaria

St Luke's Medical Center Global City Philippines

Stroke Center IRCCS Sacro Cuore Don Calabria Verona Italy

Stroke Department of Medicine Nottingham University Hospitals NHS Trust Nottingham United Kingdom

Stroke Unit Centro Hospitalar Universitário de Lisboa Central Lisbon Portugal

Stroke Unit Medicine Department Centro Hospitalar Universitário de São João Porto Portugal

Stroke Unit Metropolitan Hospital Piraeus Greece

Stroke Unit Neurology Department Hospital Universitario Virgen del Rocío Seville Spain

Stroke Unit Neurology Nossa Senhora da Conceição Hospital Porto Alegre Brazil

Stroke Unit University of Siena Siena Italy

SUNY Upstate New York Syracuse United States

SUNY Upstate New York USA

Toronto Western Hospital University of Toronto Toronto Canada

Toyonaka Municipal Hospital Toyonaka Japan

Uherskohradišťská Hospital Uherské Hradiště Czech Republic

Universitätsklinikum Hamburg Eppendorf Klinik und Poliklinik für Neurologie Hamburg Germany

University of Florida Gainesfille United States

University of Iowa Iowa City United States

University of Iowa Iowa USA Iowa City United States

University of Utah Salt Lake City United States

Wellington Regional Hospital Capital and Coast District Health Board Wellington New Zealand

Yokohama Brain and Spine Center Yokohama Japan

Erratum v

J Stroke. 2024 Jan;26(1):129. doi: 10.5853/jos.2022.00752.e1. PubMed

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Effect of Asymptomatic and Symptomatic COVID-19 on Acute Ischemic Stroke Revascularization Outcomes

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ClinicalTrials.gov
NCT04934020