TY  - JOUR
A1  - Schulz, Jörg B.
A1  - Berlit, Peter
A1  - Diener, Hans-Christoph
A1  - Gerloff, Christian
A1  - Greinacher, Andreas
A1  - Klein, Christine
A1  - Petzold, Gabor
A1  - Piccininni, Marco
A1  - Poli, Sven
A1  - Röhrig, Rainer
A1  - Steinmetz, Helmuth
A1  - Thiele, Thomas
A1  - Kurth, Tobias
T1  - COVID-19 vaccine-associated cerebral venous thrombosis in Germany
T2  - Annals of neurology
N2  - 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.
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63921
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-639214
SN  - 1531-8249
N1  - Open Access funding enabled and organized by Projekt DEAL.
VL  - 90
IS  - 4
SP  - 627
EP  - 639
PB  - Wiley-Blackwell
CY  - Hoboken, NJ
ER  -