Cerebral venous thrombosis after ChAdOx1 nCoV-19 vaccination: a systematic review

T. J. Song, J. I. Shin, D. K. Yon, S. W. Lee, S. Y. Hwang, J. Hwang, S. H. Park, S. B. Lee, M. H. Lee, M. S. Kim, A. Koyanagi, K. Tizaoui, J. H. Kim, L. Smith

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


OBJECTIVE: To perform a systematic review of case reports or case series regarding thrombosis with thrombocytopenia syndrome (TTS) and cerebral venous thrombosis (CVT) related to ChAdOx1 nCoV-19 vaccination to address the clinical features, laboratory findings, treatment modalities, and prognosis related with CVT. SUBJECTS AND METHODS: We included 64 TTS patients from 19 articles, 6 case series and 13 case reports, in which thrombosis occurred after the first dose of ChAdOx1 nCoV-19 vaccination published up to 30 June 2021 in Embase, ePubs, Medline/PubMed, Scopus, and Web of Science databases. RESULTS: Of the 64 TTS patients, 38 (59.3%) had CVT. Patients with CVT were younger (median 36.5 vs. 52.5 years, p<0.001), had lower fibrinogen levels (130 vs. 245 mg/dL, p=0.008), had more frequent history of intracerebral hemorrhage (ICH), and had higher mortality rate (48.6% vs. 19.2%, p=0.020) than that of patients without CVT. In multivariable analysis, the possibility of presence of CVT was higher in younger age groups [odd ratio (OR): 0.91, 95% confidence interval (CI): (0.86-0.97, p<0.001)] and those with accompanying intracerebral hemorrhage (ICH) (OR: 13.60, 95% CI (1.28-144.12, p=0.045). CONCLUSIONS: Our study demonstrated that CVT related to ChAdOx1 nCoV-19 vaccination was associated with younger age, low levels of fibrinogen, presence of ICH and more frequent mortality compared to those of non-CVT. If TTS occurs after ChAdOx1 nCoV-19 vaccination, the presence of CVT in patients with young age or ICH should be considered.

Original languageEnglish
Pages (from-to)404-410
Number of pages7
JournalEuropean Review for Medical and Pharmacological Sciences
Issue number1
StatePublished - 2023

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  • COVID-19
  • Cerebral venous thrombosis
  • ChAdOx1 nCoV-19 vaccine
  • Intracerebral hemorrhage
  • Prognosis
  • Thrombosis with thrombocytopenia syndrome


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