Evidence map›Paper›PMID 34610990›Full record

SynthesisNeurology2021

Cerebral Venous Sinus Thrombosis and Thrombotic Events After Vector-Based COVID-19 Vaccines: A Systematic Review and Meta-analysis.

Lina Palaiodimou, Maria-Ioanna Stefanou, Aristeidis H Katsanos, Diana Aguiar de Sousa, Jonathan M Coutinho, Pagona Lagiou, Ioannis Michopoulos, Androniki Naska, Sotirios Giannopoulos, Konstantinos Vadikolias and 5 more

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 1 pooled it
12.1field-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

26 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.

  1. Pooled it
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  16. Vaccine-induced immune thrombotic thrombocytopenia.Best practice & research. Clinical haematology · 2022
    Review
  17. Asia Pacific perspectives on the second year of the COVID-19 pandemic: A follow-up survey.Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2022
    Article
  18. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 1 institution in 5 countries.

Lina PalaiodimouFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Maria-Ioanna StefanouFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Aristeidis H KatsanosFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Diana Aguiar de SousaFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.ORCID 0000-0002-6702-7924
Jonathan M CoutinhoFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Pagona LagiouFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Ioannis MichopoulosFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Androniki NaskaFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Sotirios GiannopoulosFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.ORCID 0000-0001-7443-5179
Konstantinos VadikoliasFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Konstantinos I VoumvourakisFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Vasiliki PapaevangelouFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Theodoros I VassilakopoulosFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Sotirios TsiodrasFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis.
Georgios TsivgoulisFrom the Second Department of Neurology (L.P., M.-I.S., A.H.K., S.G., K.I.V., G.T.), Second Department of Psychiatry (I.M.), and Fourth Department of Internal Medicine (S.T.), "Attikon" University Hospital, Department of Hygiene, Epidemiology and Medical Statistics (P.L., A.N.), School of Medicine, and Third Department of Critical Care Medicine, Evgenideio Hospital, Medical School (T.I.V.), and Third Department of Pediatrics (V.P.), National and Kapodistrian University of Athens, Greece; Division of Neurology (A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Canada; Department of Neurosciences and Mental Health (D.A.d.S.), Hospital de Santa Maria, CHULN, University of Lisbon, Portugal; Department of Neurology (J.M.C.), Amsterdam UMC, University of Amsterdam, the Netherlands; Department of Epidemiology (P.L.), Harvard T.H. Chan School of Public Health, Boston, MA; Department of Neurology (K.V.), University Hospital of Alexandroupolis, Democritus University of Thrace; Hellenic Centre for Disease Control and Prevention (S.T.), Athens, Greece; and Department of Neurology (G.T.), University of Tennessee Health Science Center, Memphis. tsivgoulisgiorg@yahoo.gr.
Harvard University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesThere is accumulating evidence supporting an association between the thrombosis and thrombocytopenia syndrome (TTS) and adenovirus vector-based vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Yet TTS and TTS-associated cerebral venous sinus thrombosis (CVST) remain poorly characterized. We aim to systematically evaluate the proportion of CVST among TTS cases and assess its characteristics and outcomes.

methodsWe performed a systematic review and meta-analysis of clinical trials, cohorts, case series, and registry-based studies with the aim to assess (1) the pooled mortality rate of CVST, TTS-associated CVST, and TTS and (2) the pooled proportion of patients with CVST among patients with any thrombotic event and TTS. Secondary outcomes comprised clinical characteristics of patients with postvaccination thrombotic event. This meta-analysis is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was written according to the Meta-analysis of Observational Studies in Epidemiology proposal.

resultsSixty-nine studies were included in the qualitative analysis comprising 370 patients with CVST out of 4,182 patients with any thrombotic event associated with SARS-CoV-2 vector-based vaccine administration. Twenty-three studies were included further in quantitative meta-analysis. Among TTS cases, the pooled proportion of CVST was 51% (95% confidence interval [CI] 36%-66%; DISCUSSION: Approximately half of patients with TTS present with CVST; almost one-third of patients with TTS do not survive. Further research is required to identify independent predictors of TTS following adenovirus vector-based vaccination. REGISTRATION INFORMATION: The prespecified study protocol has been registered in the International Prospective Register of Ongoing Systematic Reviews PROSPERO (CRD42021250709).

Indexed as

COVID-19 VaccinesSinus Thrombosis, IntracranialThrombocytopeniaThrombosisCOVID-19FemaleHumansMiddle AgedSARS-CoV-2COVID-19 Vaccines

Identifiers

PMID34610990
OpenAlexW3201683004

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