Cerebral venous thrombosis in Covid-19

Abstract

Introduction: COVID-19 is increasingly linked to thromboembolic events. Cerebral venous thrombosis (CVT) for instance, is a rare and serious neurological complication that is more and more reported in covid-19 patients.

Objectives: To present the characteristics of patients with a concomitant covid-19 infection and CVT.

Methods: We conducted a retrospective study including covid-19 patients hospitalized in our pulmonology department between March 2020 and February 2021. We recorded clinical characteristics, imagery findings and outcomes of patients that developed a CVT.

Results: We have included one thousand patients. Three patients developed a CVT (0,3%) : 1 woman and 2 men. Ages were 45, 47, and 23 years. One man has a history of ulcerative colitis and was under steroids. Two patients had no medical history. The median time from covid-19 and CVT symptoms was 10 days. The woman developed a peripheral facial paralysis while the 2 men presented with generalized seizures. Chest CT-scan estimated lobar involvement under 10% for all these patients. CVT was localised in both the sigmoid and lateral sinuses in 1 case and in the superior sagittal sinus in the other 2 cases. These patients were prescribed with a low-molecular weight heparin and a vitamin k antagonist. The two men were also prescribed with antiepileptic drugs and presented no recurrence of seizures. The women showed a complete regression of peripheral facial paralysis in 10 days. All three patients were discharged from the hospital in good condition.

Conclusion: Cerebral venous thrombosis associated with covid-19 is a rare complication that usually occurs in young adults. It may touch patients with no medical history and with a mild covid-19 infection.