Neurology: Overview of the risk of cerebral venous sinus thrombosis after 4 SARS-CoV-2 vaccinations, young people bear the brunt

Vaccination is the most effective way to fight the COVID-19 pandemic
.

Four vaccines against SARSCoV-2 have been positively evaluated by the European Medicines Agency (EMA): 2 adenoviral vector vaccines (ChAdOx1 NCoV-19, AstraZeneca/Oxford and Ad26.

COVID -19 administration 2 adenoviral vector vaccines (ChAdOx1 NCoV-19, AstraZeneca/Oxford and Ad26.

The COVID-19 vaccination campaign has hit a snag after cases of cerebral venous sinus thrombosis (CVST) and other unusual site thrombosis were reported in individuals recently vaccinated with adenoviral vector vaccines

Cerebral venous sinus thrombosis (CVST) is a rare adverse drug reaction following SARS-CoV-2 vaccination and is part of the thrombosis and thrombocytopenia syndrome
.

The estimated background incidence of CVST with thrombocytopenia is 0.
1 per million per month

We assessed the age-stratified risk of CVST with and without thrombocytopenia following SARSCoV-2 vaccination

Using data from the European Medicines Agency's EudraVigilance database (until 13 June 2021), the researchers estimated the risk of thrombocytopenia with and without the 28 days following the first dose of four SARS-CoV-2 vaccines Absolute risk of CVST
.

As the denominator, the researchers used vaccine delivery data from 31 European countries

• The absolute risk of CVST within 28 days after the first vaccination with ChAdOx1NCoV-19, Ad26.
  COV2.
  S, BNT162b2 and mRNA-1273 was 7.
  5 (95%CI 6.
  9-8.
  3), 0.
  7 (95%CI 0.
  2-2.
  4), 0.
  6 (95 %CI 0.
  5~0.
  7) and 0.
  6 (95%CI 0.
  3~1.
  1);
• The absolute risks of developing CVST with thrombocytopenia within 28 days after the first vaccination with ChAdOx1NCoV-19, Ad26.
  COV2.
  S, BNT162b2 and mRNA-1273 were 4.
  4 (95%CI 3.
  9-4.
  9), 0.
  7 (95%CI 0.
  2-2.
  4), 0.
  0(95%CI 0.
  0~0.
  1) and 0.
  0(95%CI 0.
  0~0.
  2)/million;
• Among patients treated with ChAdOx1NCoV-19, the 18-24-year-old age group had the highest absolute risk of developing CVST (7.
  3‰, 95% CI 2.
  818.
  8‰ and 3.
  7‰, 95% CI 1.
  0-13.
  3) ;
• The risk of CVST and thrombocytopenia in CHAdOx1NCoV-19 recipients was the lowest in the ≥70-year-old age group (0.
  2, 95%CI 0.
  0-1.
  3);
• Compared with ≥, age < 60 years was a predictor of combined thrombocytopenia (incidence ratio 5.
  7995% CI 2.
  9811.
  24, p < 0.
  001)
  .
  

The absolute risk of CVST within 28 days after the first vaccination with ChAdOx1NCoV-19, Ad26.
COV2.
S, BNT162b2 and mRNA-1273 was 7.
5 (95%CI 6.
9-8.
3), 0.
7 (95%CI 0.
2-2.
4), 0.
6 (95 %CI 0.
5~0.
7) and 0.
6 (95%CI 0.
3~1.
1);

Absolute risk of CVST within 28 days

The absolute risks of developing CVST with thrombocytopenia within 28 days after the first vaccination with ChAdOx1NCoV-19, Ad26.
COV2.
S, BNT162b2 and mRNA-1273 were 4.
4 (95%CI 3.
9-4.
9), 0.
7 (95%CI 0.
2-2.
4), 0.
0(95%CI 0.
0~0.
1) and 0.
0(95%CI 0.
0~0.
2)/million;

Absolute risk of developing CVST with thrombocytopenia within 28 days

Among patients treated with ChAdOx1NCoV-19, the 18-24-year-old age group had the highest absolute risk of developing CVST (7.
3‰, 95% CI 2.
818.
8‰ and 3.
7‰, 95% CI 1.
0-13.
3) ;

18-24 year old age group

The risk of CVST and thrombocytopenia in CHAdOx1NCoV-19 recipients was the lowest in the ≥70-year-old age group (0.
2, 95%CI 0.
0-1.
3);

≥70 years old age group

Compared with ≥, age < 60 years was a predictor of combined thrombocytopenia (incidence ratio 5.
7995% CI 2.
9811.
24, p < 0.
001)
.

Age < 60 years old

      The risk of developing CVST with thrombocytopenia within 28 days of the first ChAdOx1 NCoV-19 vaccine was higher in younger populations
.

Compared with the estimated background risk, patients treated with Ad26.

The risk of developing CVST with thrombocytopenia within 28 days of the first ChAdOx1 NCoV-19 vaccine was higher in younger populations

Krzywicka K, van de Munckhof A, Sánchez van Kammen M, et al.
Age-Stratified Risk of Cerebral Venous Sinus Thrombosis After SARS-CoV-2 Vaccination [published online ahead of print, 2021 Dec 17].
Neurology.
2021;10.
1212/ WNL.
0000000000013148.
doi:10.
1212/WNL.
0000000000013148Leave a message here