Cerebral venous thrombosis and severe acute respiratory syndrome coronavirus‐2 infection: A systematic review and meta‐analysis

Cerebral venous thrombosis (CVT) is one of the diagnoses reported in coronavirus disease 2019 (COVID-19 patients). Meanwhile, the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has the potential to cause endothelial dysfunction, increase thrombin generation and inhibit fibrinolysis. This causes hyper coagulopathy, with the potential to become CVT. Therefore, this study aims to determine the characteristics of CVT cases in COVID-19 patients. This systematic review refers to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-analysis) guidelines. The articles were obtained systematically from online databases, Pubmed, Science Direct, as well as Google Scholar, using the search keywords ("COVID 19" OR "SARS-CoV-2 infection" OR "COVID-19 virus disease" OR "2019-nCoV infection" OR "coronavirus disease 2019" OR "coronavirus disease-19" OR "2019- nCoV disease "OR" COVID-19 virus infection") AND" cerebral venous thrombosis " as well as " cerebral venous thrombosis ". After deduplication, eligibility criteria selection and critical assessment on journals, the study reviewed eight patients from four case reports and two case series. According to the characterization, CVT patients with COVID-19 had a mean age of 42.4 years, were mostly male, tended to be cryptogenic, as well as varied neurological symptoms, and increased D-Dimer in most cases. All patients showed CVT features on imaging and were treated using mostly anticoagulants. Five out of the eight patients (50%) died.

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A systematic review and meta-analysis on endovascular treatment as an attractive alternative for acute superior mesenteric venous thrombosis

Vascular ◽

10.1177/1708538121991270 ◽

2021 ◽

pp. 170853812199127

Author(s):

Lixin Wang ◽

Enci Wang ◽

Fei Liu ◽

Wei Zhang ◽

Xiaolong Shu ◽

...

Keyword(s):

Systematic Review ◽

Treatment Group ◽

Conservative Treatment ◽

Venous Thrombosis ◽

Endovascular Treatment ◽

Meta Analysis ◽

Statistical Significance ◽

Published Data ◽

Mesenteric Venous Thrombosis ◽

Surgery Group

Objective This systematic review and meta-analysis evaluated the published data on the efficacy and safety of therapies for superior mesenteric venous thrombosis (SMVT), aiming to provide a reference and set of recommendations for clinical treatment. Methods Relevant databases were searched for studies published from 2000 to June 2020 on SMVT treated with conservative treatment, surgical treatment, or endovascular approach. Different treatment types were grouped for analysis and comparison, and odds ratios with corresponding 95% confidence intervals were calculated. The outcomes were pooled using meta-analytic methods and presented by forest plots. Results Eighteen articles, including eight on SMVT patients treated with endovascular therapies, were enrolled. The treatment effectiveness was compared between different groups according to the change of symptoms, the occurrence of complications, and mortality as well. The conservative treatment group had better efficacy compared to the surgery group (89.0% vs. 78.6%, P <0.05), and the one-year survival rate was also higher (94.4% vs. 80.0%, P >0.05), but without statistical significance. As for endovascular treatment, the effectiveness was significantly higher than the surgery group (94.8% vs. 75.2%, P <0.05), and the conservative treatment group as well (93.3% vs. 86.3%, P >0.05), which still requires further research for the lack of statistical significance. Conclusions Present findings indicate that anticoagulation, as conservative treatment should be the preferred clinical option in the clinic for SMVT, due to its better curative effect compared to other treatment options, including lower mortality, fewer complications, and better prognosis. Moreover, endovascular treatment is a feasible and promising approach that is worth in-depth research, for it is less invasive than surgery and has relatively better effectiveness, thus can provide an alternative option for SMVT treatment and may be considered as a reliable method in clinical.

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