An increase in the incidence of cerebral venous-sinus thrombosis in 2020: Spanish observational cohort study

Background and Aims: Cerebral venous-sinus thrombosis (CVST) is an uncommon cause of stroke, accounting for 0.5-1% of all stroke cases. As Covid-19 increases the risk of thrombotic events, we aimed to evaluate incidence and features of patients with CVST diagnosed during 2020. Methods: Patients diagnosed with CVSTat our stroke centre in the past 5 years were analysed from our prospective database. They were divided in two groups according to symptoms onset, group 1 (2016-2019) and group 2 (year 2020). Demographic, clinical, radiological, laboratory, and follow-up data were collected. We evaluated the differences in the incidence and data collected in the two groups. Results: 95 CVST patients were included (median age 41.58+-16.5;60% female). 69 patients were included in group 1 and 26 in group 2. The two groups differed in disease incidence (group 1 vs group 2: 1.15 vs 2.16 per month) and mean age (43+/-15,6 vs 38+/-18,6 years, p=0.07). Only 1 CVST patient was related to Covid-19 infection. CSVT in 2020 were more associated with thrombophilia (57.7% vs 33.3%;p=0.02) and had less supratentorial lesions (16.7% vs 42.6%;p=0.027). No patients died in 2020. In addition, patients had less disability at discharge (Rankin2 in 8% vs 27.9%;p=0.051). We found no differences in D-dimer values. Conclusions: During Covid-19 pandemic,we found a 2 two-fold increased incidence of CVST,although most of them not clearly related with Covid-19 infection. Patients in 2020 had less supratentorial lesions and less disability at discharge than previous years. Further studies are needed to confirm this increased incidence and its causes in other cohorts.