Cerebral Venous Thrombosis Associated with COVID-19.
Identifieur interne : 001382 ( Main/Corpus ); précédent : 001381; suivant : 001383Cerebral Venous Thrombosis Associated with COVID-19.
Auteurs : D D Cavalcanti ; E. Raz ; M. Shapiro ; S. Dehkharghani ; S. Yaghi ; K. Lillemoe ; E. Nossek ; J. Torres ; R. Jain ; H A Riina ; A. Radmanesh ; P K NelsonSource :
- AJNR. American journal of neuroradiology [ 1936-959X ] ; 2020.
English descriptors
- KwdEn :
- Adult (MeSH), Azithromycin (therapeutic use), Betacoronavirus (MeSH), COVID-19 (MeSH), Coronavirus Infections (complications), Coronavirus Infections (drug therapy), Female (MeSH), Humans (MeSH), Hydroxychloroquine (therapeutic use), Intracranial Thrombosis (etiology), Male (MeSH), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (drug therapy), Ritonavir (therapeutic use), SARS-CoV-2 (MeSH), Venous Thrombosis (chemically induced), Venous Thrombosis (etiology), Young Adult (MeSH).
- MESH :
- chemical , therapeutic use : Azithromycin, Hydroxychloroquine, Ritonavir.
- chemically induced : Venous Thrombosis.
- complications : Coronavirus Infections, Pneumonia, Viral.
- drug therapy : Coronavirus Infections, Pneumonia, Viral.
- etiology : Intracranial Thrombosis, Venous Thrombosis.
- Adult, Betacoronavirus, COVID-19, Female, Humans, Male, Pandemics, SARS-CoV-2, Young Adult.
Abstract
Despite the severity of coronavirus disease 2019 (COVID-19) being more frequently related to acute respiratory distress syndrome and acute cardiac and renal injuries, thromboembolic events have been increasingly reported. We report a unique series of young patients with COVID-19 presenting with cerebral venous system thrombosis. Three patients younger than 41 years of age with confirmed Severe Acute Respiratory Syndrome coronavirus 2 (SARS-Cov-2) infection had neurologic findings related to cerebral venous thrombosis. They were admitted during the short period of 10 days between March and April 2020 and were managed in an academic institution in a large city. One patient had thrombosis in both the superficial and deep systems; another had involvement of the straight sinus, vein of Galen, and internal cerebral veins; and a third patient had thrombosis of the deep medullary veins. Two patients presented with hemorrhagic venous infarcts. The median time from COVID-19 symptoms to a thrombotic event was 7 days (range, 2-7 days). One patient was diagnosed with new-onset diabetic ketoacidosis, and another one used oral contraceptive pills. Two patients were managed with both hydroxychloroquine and azithromycin; one was treated with lopinavir-ritonavir. All patients had a fatal outcome. Severe and potentially fatal deep cerebral thrombosis may complicate the initial clinical presentation of COVID-19. We urge awareness of this atypical manifestation.
DOI: 10.3174/ajnr.A6644
PubMed: 32554424
PubMed Central: PMC7658892
Links to Exploration step
pubmed:32554424Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Cerebral Venous Thrombosis Associated with COVID-19.</title><author><name sortKey="Cavalcanti, D D" sort="Cavalcanti, D D" uniqKey="Cavalcanti D" first="D D" last="Cavalcanti">D D Cavalcanti</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author><author><name sortKey="Raz, E" sort="Raz, E" uniqKey="Raz E" first="E" last="Raz">E. Raz</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.) eytan.raz@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Shapiro, M" sort="Shapiro, M" uniqKey="Shapiro M" first="M" last="Shapiro">M. Shapiro</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author><author><name sortKey="Dehkharghani, S" sort="Dehkharghani, S" uniqKey="Dehkharghani S" first="S" last="Dehkharghani">S. Dehkharghani</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author><author><name sortKey="Yaghi, S" sort="Yaghi, S" uniqKey="Yaghi S" first="S" last="Yaghi">S. Yaghi</name><affiliation><nlm:affiliation>Neurology (S.Y., K.L., J.T.).</nlm:affiliation></affiliation></author><author><name sortKey="Lillemoe, K" sort="Lillemoe, K" uniqKey="Lillemoe K" first="K" last="Lillemoe">K. Lillemoe</name><affiliation><nlm:affiliation>Neurology (S.Y., K.L., J.T.).</nlm:affiliation></affiliation></author><author><name sortKey="Nossek, E" sort="Nossek, E" uniqKey="Nossek E" first="E" last="Nossek">E. Nossek</name><affiliation><nlm:affiliation>Neurosurgery (E.N., H.A.R.), NYU Grossman School of Medicine, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Torres, J" sort="Torres, J" uniqKey="Torres J" first="J" last="Torres">J. Torres</name><affiliation><nlm:affiliation>Neurology (S.Y., K.L., J.T.).</nlm:affiliation></affiliation></author><author><name sortKey="Jain, R" sort="Jain, R" uniqKey="Jain R" first="R" last="Jain">R. Jain</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author><author><name sortKey="Riina, H A" sort="Riina, H A" uniqKey="Riina H" first="H A" last="Riina">H A Riina</name><affiliation><nlm:affiliation>Neurosurgery (E.N., H.A.R.), NYU Grossman School of Medicine, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Radmanesh, A" sort="Radmanesh, A" uniqKey="Radmanesh A" first="A" last="Radmanesh">A. Radmanesh</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author><author><name sortKey="Nelson, P K" sort="Nelson, P K" uniqKey="Nelson P" first="P K" last="Nelson">P K Nelson</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32554424</idno><idno type="pmid">32554424</idno><idno type="doi">10.3174/ajnr.A6644</idno><idno type="pmc">PMC7658892</idno><idno type="wicri:Area/Main/Corpus">001382</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001382</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Cerebral Venous Thrombosis Associated with COVID-19.</title><author><name sortKey="Cavalcanti, D D" sort="Cavalcanti, D D" uniqKey="Cavalcanti D" first="D D" last="Cavalcanti">D D Cavalcanti</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author><author><name sortKey="Raz, E" sort="Raz, E" uniqKey="Raz E" first="E" last="Raz">E. Raz</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.) eytan.raz@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Shapiro, M" sort="Shapiro, M" uniqKey="Shapiro M" first="M" last="Shapiro">M. Shapiro</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author><author><name sortKey="Dehkharghani, S" sort="Dehkharghani, S" uniqKey="Dehkharghani S" first="S" last="Dehkharghani">S. Dehkharghani</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author><author><name sortKey="Yaghi, S" sort="Yaghi, S" uniqKey="Yaghi S" first="S" last="Yaghi">S. Yaghi</name><affiliation><nlm:affiliation>Neurology (S.Y., K.L., J.T.).</nlm:affiliation></affiliation></author><author><name sortKey="Lillemoe, K" sort="Lillemoe, K" uniqKey="Lillemoe K" first="K" last="Lillemoe">K. Lillemoe</name><affiliation><nlm:affiliation>Neurology (S.Y., K.L., J.T.).</nlm:affiliation></affiliation></author><author><name sortKey="Nossek, E" sort="Nossek, E" uniqKey="Nossek E" first="E" last="Nossek">E. Nossek</name><affiliation><nlm:affiliation>Neurosurgery (E.N., H.A.R.), NYU Grossman School of Medicine, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Torres, J" sort="Torres, J" uniqKey="Torres J" first="J" last="Torres">J. Torres</name><affiliation><nlm:affiliation>Neurology (S.Y., K.L., J.T.).</nlm:affiliation></affiliation></author><author><name sortKey="Jain, R" sort="Jain, R" uniqKey="Jain R" first="R" last="Jain">R. Jain</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author><author><name sortKey="Riina, H A" sort="Riina, H A" uniqKey="Riina H" first="H A" last="Riina">H A Riina</name><affiliation><nlm:affiliation>Neurosurgery (E.N., H.A.R.), NYU Grossman School of Medicine, New York, New York.</nlm:affiliation></affiliation></author><author><name sortKey="Radmanesh, A" sort="Radmanesh, A" uniqKey="Radmanesh A" first="A" last="Radmanesh">A. Radmanesh</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author><author><name sortKey="Nelson, P K" sort="Nelson, P K" uniqKey="Nelson P" first="P K" last="Nelson">P K Nelson</name><affiliation><nlm:affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</nlm:affiliation></affiliation></author></analytic><series><title level="j">AJNR. American journal of neuroradiology</title><idno type="eISSN">1936-959X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Azithromycin (therapeutic use)</term><term>Betacoronavirus (MeSH)</term><term>COVID-19 (MeSH)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (drug therapy)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Intracranial Thrombosis (etiology)</term><term>Male (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (drug therapy)</term><term>Ritonavir (therapeutic use)</term><term>SARS-CoV-2 (MeSH)</term><term>Venous Thrombosis (chemically induced)</term><term>Venous Thrombosis (etiology)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Azithromycin</term><term>Hydroxychloroquine</term><term>Ritonavir</term></keywords><keywords scheme="MESH" qualifier="chemically induced" xml:lang="en"><term>Venous Thrombosis</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Intracranial Thrombosis</term><term>Venous Thrombosis</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Betacoronavirus</term><term>COVID-19</term><term>Female</term><term>Humans</term><term>Male</term><term>Pandemics</term><term>SARS-CoV-2</term><term>Young Adult</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Despite the severity of coronavirus disease 2019 (COVID-19) being more frequently related to acute respiratory distress syndrome and acute cardiac and renal injuries, thromboembolic events have been increasingly reported. We report a unique series of young patients with COVID-19 presenting with cerebral venous system thrombosis. Three patients younger than 41 years of age with confirmed Severe Acute Respiratory Syndrome coronavirus 2 (SARS-Cov-2) infection had neurologic findings related to cerebral venous thrombosis. They were admitted during the short period of 10 days between March and April 2020 and were managed in an academic institution in a large city. One patient had thrombosis in both the superficial and deep systems; another had involvement of the straight sinus, vein of Galen, and internal cerebral veins; and a third patient had thrombosis of the deep medullary veins. Two patients presented with hemorrhagic venous infarcts. The median time from COVID-19 symptoms to a thrombotic event was 7 days (range, 2-7 days). One patient was diagnosed with new-onset diabetic ketoacidosis, and another one used oral contraceptive pills. Two patients were managed with both hydroxychloroquine and azithromycin; one was treated with lopinavir-ritonavir. All patients had a fatal outcome. Severe and potentially fatal deep cerebral thrombosis may complicate the initial clinical presentation of COVID-19. We urge awareness of this atypical manifestation.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" IndexingMethod="Curated" Owner="NLM"><PMID Version="1">32554424</PMID><DateCompleted><Year>2020</Year><Month>08</Month><Day>24</Day></DateCompleted><DateRevised><Year>2020</Year><Month>12</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1936-959X</ISSN><JournalIssue CitedMedium="Internet"><Volume>41</Volume><Issue>8</Issue><PubDate><Year>2020</Year><Month>08</Month></PubDate></JournalIssue><Title>AJNR. American journal of neuroradiology</Title><ISOAbbreviation>AJNR Am J Neuroradiol</ISOAbbreviation></Journal><ArticleTitle>Cerebral Venous Thrombosis Associated with COVID-19.</ArticleTitle><Pagination><MedlinePgn>1370-1376</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.3174/ajnr.A6644</ELocationID><Abstract><AbstractText>Despite the severity of coronavirus disease 2019 (COVID-19) being more frequently related to acute respiratory distress syndrome and acute cardiac and renal injuries, thromboembolic events have been increasingly reported. We report a unique series of young patients with COVID-19 presenting with cerebral venous system thrombosis. Three patients younger than 41 years of age with confirmed Severe Acute Respiratory Syndrome coronavirus 2 (SARS-Cov-2) infection had neurologic findings related to cerebral venous thrombosis. They were admitted during the short period of 10 days between March and April 2020 and were managed in an academic institution in a large city. One patient had thrombosis in both the superficial and deep systems; another had involvement of the straight sinus, vein of Galen, and internal cerebral veins; and a third patient had thrombosis of the deep medullary veins. Two patients presented with hemorrhagic venous infarcts. The median time from COVID-19 symptoms to a thrombotic event was 7 days (range, 2-7 days). One patient was diagnosed with new-onset diabetic ketoacidosis, and another one used oral contraceptive pills. Two patients were managed with both hydroxychloroquine and azithromycin; one was treated with lopinavir-ritonavir. All patients had a fatal outcome. Severe and potentially fatal deep cerebral thrombosis may complicate the initial clinical presentation of COVID-19. We urge awareness of this atypical manifestation.</AbstractText><CopyrightInformation>© 2020 by American Journal of Neuroradiology.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Cavalcanti</LastName><ForeName>D D</ForeName><Initials>DD</Initials><Identifier Source="ORCID">0000-0002-2284-9297</Identifier><AffiliationInfo><Affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Raz</LastName><ForeName>E</ForeName><Initials>E</Initials><Identifier Source="ORCID">0000-0003-2998-8481</Identifier><AffiliationInfo><Affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.) eytan.raz@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Shapiro</LastName><ForeName>M</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0003-1279-5456</Identifier><AffiliationInfo><Affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dehkharghani</LastName><ForeName>S</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0002-3141-1094</Identifier><AffiliationInfo><Affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Yaghi</LastName><ForeName>S</ForeName><Initials>S</Initials><Identifier Source="ORCID">0000-0003-0031-1004</Identifier><AffiliationInfo><Affiliation>Neurology (S.Y., K.L., J.T.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lillemoe</LastName><ForeName>K</ForeName><Initials>K</Initials><Identifier Source="ORCID">0000-0002-5666-9411</Identifier><AffiliationInfo><Affiliation>Neurology (S.Y., K.L., J.T.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nossek</LastName><ForeName>E</ForeName><Initials>E</Initials><Identifier Source="ORCID">0000-0003-2750-421X</Identifier><AffiliationInfo><Affiliation>Neurosurgery (E.N., H.A.R.), NYU Grossman School of Medicine, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Torres</LastName><ForeName>J</ForeName><Initials>J</Initials><Identifier Source="ORCID">0000-0001-6026-4938</Identifier><AffiliationInfo><Affiliation>Neurology (S.Y., K.L., J.T.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jain</LastName><ForeName>R</ForeName><Initials>R</Initials><Identifier Source="ORCID">0000-0002-4879-0457</Identifier><AffiliationInfo><Affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Riina</LastName><ForeName>H A</ForeName><Initials>HA</Initials><Identifier Source="ORCID">0000-0002-9303-8176</Identifier><AffiliationInfo><Affiliation>Neurosurgery (E.N., H.A.R.), NYU Grossman School of Medicine, New York, New York.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Radmanesh</LastName><ForeName>A</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0002-8581-2600</Identifier><AffiliationInfo><Affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Nelson</LastName><ForeName>P K</ForeName><Initials>PK</Initials><Identifier Source="ORCID">0000-0003-2805-7669</Identifier><AffiliationInfo><Affiliation>From the Departments of Radiology (D.D.C., E.R., M.S., S.D., R.J., A.R., P.K.N.).</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>18</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>AJNR Am J Neuroradiol</MedlineTA><NlmUniqueID>8003708</NlmUniqueID><ISSNLinking>0195-6108</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical><Chemical><RegistryNumber>83905-01-5</RegistryNumber><NameOfSubstance UI="D017963">Azithromycin</NameOfSubstance></Chemical><Chemical><RegistryNumber>O3J8G9O825</RegistryNumber><NameOfSubstance UI="D019438">Ritonavir</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Protocol" UI="C000705127">COVID-19 drug treatment</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017963" MajorTopicYN="N">Azithromycin</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="Y">Betacoronavirus</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000086382" MajorTopicYN="N">COVID-19</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName 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