Evidence map›Paper›PMID 34536256›Full record

ArticleEuropean journal of neurology2022

Declining mortality of cerebral venous sinus thrombosis with thrombocytopenia after SARS-CoV-2 vaccination.

Anita van de Munckhof, Katarzyna Krzywicka, Diana Aguiar de Sousa, Mayte Sánchez van Kammen, Mirjam R Heldner, Katarina Jood, Erik Lindgren, Turgut Tatlisumak, Jukka Putaala, Johanna A Kremer Hovinga and 5 more

Open access · hybridAbstract read
In one paragraph

Article in European journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 1 pooled it
9.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.

  1. Pooled it
  2. The immunogenicity and safety of adenoviral-based vaccines.Current opinion in allergy and clinical immunology · 2026
    Review
  3. Cerebral venous thrombosis: Current management, recent advances and future directions.International journal of stroke : official journal of the International Stroke Society · 2025
    Review
  4. Review
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Review
  12. Cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia in middle-income countries.International journal of stroke : official journal of the International Stroke Society · 2023
    Article
  13. Co-VAN study: COVID-19 vaccine associated neurological diseases- an experience from an apex neurosciences centre and review of the literature.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2023
    Review
  14. Review
  15. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 7 institutions in 6 countries.

Anita van de MunckhofDepartment of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Katarzyna KrzywickaDepartment of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Diana Aguiar de SousaDepartment of Neurosciences and Mental Health, Neurology Service, Hospital de Santa Maria/CHULN, University of Lisbon, Lisbon, Portugal.ORCID 0000-0002-6702-7924
Mayte Sánchez van KammenDepartment of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Mirjam R HeldnerDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0002-3594-2159
Katarina JoodDepartment of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.
Erik LindgrenDepartment of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.ORCID 0000-0002-7628-5044
Turgut TatlisumakDepartment of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden.ORCID 0000-0002-2430-8988
Jukka PutaalaDepartment of Neurology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Johanna A Kremer HovingaDepartment of Hematology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Saskia MiddeldorpDepartment of Internal Medicine, Radboud Institute of Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands.ORCID 0000-0002-1006-6420
Marcel LeviBiomedical Research Centre, National Institute for Health Research, University College London Hospitals (UCLH), London, UK.ORCID 0000-0002-2212-5299
Marcel ArnoldDepartment of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.ORCID 0000-0002-4274-4644
José M FerroDepartment of Neurosciences and Mental Health, Neurology Service, Hospital de Santa Maria/CHULN, University of Lisbon, Lisbon, Portugal.ORCID 0000-0002-2343-9097
Jonathan M CoutinhoDepartment of Neurology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0002-8284-982X
Amsterdam University Medical Centers · NLSahlgrenska University Hospital · SEUniversity of Bern · CHUniversity of Lisbon · PTNational Institute for Health Research · GBRadboud University Nijmegen · NLUniversity of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeHigh mortality rates have been reported in patients with cerebral venous sinus thrombosis (CVST) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) after vaccination with adenoviral vector SARS-CoV-2 vaccines. The aim of this study was to evaluate whether the mortality of patients with CVST-VITT has decreased over time.

methodsThe EudraVigilance database of the European Medicines Agency was used to identify cases of CVST with concomitant thrombocytopenia occurring within 28 days of SARS-CoV-2 vaccination. Vaccines were grouped based on vaccine type (adenoviral or mRNA). Cases with CVST onset until 28 March were compared to cases after 28 March 2021, which was the day when the first scientific paper on VITT was published.

resultsIn total, 270 cases of CVST with thrombocytopenia were identified, of which 266 (99%) occurred after adenoviral vector SARS-CoV-2 vaccination (ChAdOx1 nCoV-19, n = 243; Ad26.COV2.S, n = 23). The reported mortality amongst adenoviral cases with onset up to 28 March 2021 was 47/99 (47%, 95% confidence interval 37%-58%) compared to 36/167 (22%, 95% confidence interval 16%-29%) in cases with onset after 28 March (p < 0.001). None of the four cases of CVST with thrombocytopenia occurring after mRNA vaccination died.

conclusionThe reported mortality of CVST with thrombocytopenia after vaccination with adenoviral vector-based SARS-CoV-2 vaccines has significantly decreased over time, which may indicate a beneficial effect of earlier recognition and/or improved treatment on outcome after VITT.

Indexed as

COVID-19Sinus Thrombosis, IntracranialThrombocytopeniaAd26COVS1ChAdOx1 nCoV-19COVID-19 VaccinesHumansSARS-CoV-2VaccinationAd26COVS1ChAdOx1 nCoV-19COVID-19 Vaccinescerebral venous sinus thrombosisCOVID-19 vaccinesmortalitysinus thrombosis, intracranialthrombocytopenia

Identifiers

PMID34536256
PMCPMC8652752
OpenAlexW3200407756

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.