COVID-19 Vaccine-Associated Cerebral Venous Thrombosis in Germany.

Schulz JB, Berlit P, Diener HC, Gerloff C, Greinacher A, Klein C, Petzold GC, Piccininni M, Poli S, Roehrig R, Steinmetz H, Thiele T, Kurth T (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Annals of Neurology Wiley-Blackwell

Book Volume: 90

Pages Range: 627-639

Journal Issue: 4

DOI: 10.1002/ana.26172

Abstract

OBJECTIVE: We aimed to estimate the incidence of cerebral sinus and venous thrombosis (CVT) within 1 month from first dose administration and the frequency of vaccine-induced immune thrombotic thrombocytopenia (VITT) as the underlying mechanism after vaccination with BNT162b2, ChAdOx1, and mRNA-1273, in Germany. METHODS: A web-based questionnaire was e-mailed to all departments of neurology. We requested a report of cases of CVT occurring within 1 month of a COVID-19 vaccination. Other cerebral events could also be reported. Incidence rates of CVT were calculated by using official statistics of 9 German states. RESULTS: A total of 45 CVT cases were reported. In addition, 9 primary ischemic strokes, 4 primary intracerebral hemorrhages, and 4 other neurological events were recorded. Of the CVT patients, 35 (77.8%) were female, and 36 (80.0%) were younger than 60 years. Fifty-three events were observed after vaccination with ChAdOx1 (85.5%), 9 after BNT162b2 (14.5%) vaccination, and none after mRNA-1273 vaccination. After 7,126,434 first vaccine doses, the incidence rate of CVT within 1 month from first dose administration was 0.55 (95% confidence interval [CI] = 0.38-0.78) per 100,000 person-months (which corresponds to a risk of CVT within the first 31 days of 0.55 per 100,000 individuals) for all vaccines and 1.52 (95% CI = 1.00-2.21) for ChAdOx1 (after 2,320,535 ChAdOx1 first doses). The adjusted incidence rate ratio was 9.68 (95% CI = 3.46-34.98) for ChAdOx1 compared to mRNA-based vaccines and 3.14 (95% CI = 1.22-10.65) for females compared to non-females. In 26 of 45 patients with CVT (57.8%), VITT was graded highly probable. INTERPRETATION: Given an incidence of 0.02 to 0.15 per 100,000 person-months for CVT in the general population, these findings point toward a higher risk for CVT after ChAdOx1 vaccination, especially for women. ANN NEUROL 2021;90:627-639.

Involved external institutions

Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen DE Germany (DE) Deutsche Gesellschaft für Neurologie e.V. (DGN) DE Germany (DE) Universität Duisburg-Essen (UDE) DE Germany (DE) Charité - Universitätsmedizin Berlin DE Germany (DE) Eberhard Karls Universität Tübingen DE Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) DE Germany (DE) Universitätsmedizin Greifswald / Universitätsklinikum Greifswald DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE)

How to cite

APA:

Schulz, J.B., Berlit, P., Diener, H.-C., Gerloff, C., Greinacher, A., Klein, C.,... Kurth, T. (2021). COVID-19 Vaccine-Associated Cerebral Venous Thrombosis in Germany. Annals of Neurology, 90(4), 627-639. https://doi.org/10.1002/ana.26172

MLA:

Schulz, Joerg B., et al. "COVID-19 Vaccine-Associated Cerebral Venous Thrombosis in Germany." Annals of Neurology 90.4 (2021): 627-639.

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