SARS‑CoV‑2 infection and associated risk factors for clinical cases of cerebral venous thrombosis: A case series

SARS‑CoV‑2 感染及脑静脉血栓形成临床病例的相关危险因素:病例系列

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作者:Any Axelerad, Lavinia Florenta Muja, Cristina Maria Mihai, Alina Zorina Stuparu, Anca Elena Gogu, Dragos Catalin Jianu, Corina Elena Frecus, Silviu Docu Axelerad, Silvia Georgeta Petrov, Carmen Adella Sirbu, Simona Claudia Cambrea, Radu Andrei Baz, Florentina Ionita-Radu1

Abstract

The present study focused on examining the association between the SARS-CoV-2 virus, responsible for the COVID-19 pandemic, and cerebral venous thrombosis (CVT), a specific form of stroke that affects the brain's vessels and sinuses. While COVID-19 is primarily recognized for its respiratory impact, it may also affect other organs, including the brain. One notable aspect of COVID-19 is its association with coagulopathy, an abnormal condition of blood clotting. Coagulopathy may result in various complications, including neurological ones such as stroke. The study analyzed data obtained from patients admitted to a neurology department who had confirmed neurological pathologies along with COVID-19. It specifically examined the cases of three patients with neurological conditions and COVID-19, discussing their risk factors and how their conditions progressed clinically. The study concluded that COVID-19 infection increases the likelihood of stroke, particularly within the initial 10 days after infection. CVT in particular is strongly linked to COVID-19 and its underlying mechanisms involve immune systemic processes, cytokine storms, increased blood thickness, thrombogenesis, hypercoagulability and inflammation. The presence of SARS-CoV-2 infection may worsen the procoagulant cascade, thereby affecting the clinical condition of patients with CVT. The study underscores the importance of recognizing this uncommon but treatable consequence of COVID-19 infection. Furthermore, it highlights the uniqueness of the study in evaluating COVID-19 infection in patients with CVT from Romania and South-East Europe. The findings support the existence of neurological disorders, including clotting complications in the brain's sinuses and vessels, in individuals infected with SARS-CoV-2. Several risk factors contribute to the development of CVT, such as infections, oral contraceptives, pregnancy, hematological disorders, trauma, autoimmune disorders and malignancies.

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