Introduction: COVID-19 vaccines became available after being carefully monitored in clinical trials with safety and efficacy on the human body. However, a few recipients developed unusual side effects, including cerebral venous sinus thrombosis (CVST). We aim to systematically review the baseline features, clinical characteristics, treatment, and outcomes in patients developing CVST post-COVID-19 vaccination. Methods: This study was conducted according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) 2020 guideline. Investigators independently searched PubMed, Embase, and Google Scholar for English language articles published from inception up until September 10, 2021, reporting the incidence of CVST post-COVID-19 vaccines. We analyzed CVST patients’ baseline data, type of vaccines, clinical findings, treatment, and outcomes. Our systematic review process yielded patient-level data. Result: The final analysis included 25 studies that identified 80 patients who developed CVST after the COVID-19 vaccination. Of the 80 CVST cases, 31 (39.24%) patients died. There was no significant relationship between mortality and age ( P = .733), sex ( P = .095), vaccine type ( P = .798), platelet count ( P = .93), and comorbidities such as hypertension ( P = .734) and diabetes mellitus ( P = .758). However, mortality was associated with the duration of onset of CVST symptoms after vaccination ( P = .022). Patients with CVST post-COVID-19 vaccination were more likely to survive if treated with an anticoagulant ( P = .039). Patients who developed intracranial hemorrhage ( P = .012) or thrombosis in the cortical vein ( P = .021) were more likely to die. Conclusion: COVID-19 vaccine-associated CVST is associated with high mortality rate. Timely diagnosis and management can be lifesaving for patients.
Background: There is limited and conflicting data available regarding the cardiovascular disease outcomes associated with inflammatory bowel disease (IBD). Objective: We aim to perform a systematic review to evaluate the cardiovascular outcomes and mortality associated with IBD patients. Methods: A systematic literature search has been performed on PubMed, Embase, Cochrane, and Scopus from inception till May 2022 without any language restrictions. Results: A total of 2,029,941 patients were included in the analysis from 16 studies. The mean age of the patients was 45.6 years. More females were found compared with males (57% vs 43%). The most common risk factors for cardiovascular disease (CVD) included smoking (24.19%) and alcohol (4.60%). The most common comorbidities includes hypertension (30%), diabetes mellitus (14.41%), dyslipidemia (18.42%), previous CVD (22%), and renal disease (10%). Among outcomes, all-cause mortality among IBD patients was 1.66%; ulcerative colitis (UC): 15.92%; and Crohn disease (CD): 0.30%. Myocardial Infarction (MI) among IBD patients were 1.47%, UC: 30.96%; and CD: 34.14%. CVD events among IBD patients were 1.95%. Heart failure events among IBD patients were 5.49%, stroke events among IBD patients were 0.95%, UC: 2.63%, and CD: 2.41%, respectively. Conclusion: IBD patients are at higher risk for adverse cardiovascular outcomes, especially in women. Although there remains a lack of concrete treatment algorithms and assessment parameters that better characterize IBD risk factors, nutritional modifications and physical activity should be at the forefront of CVD prevention in IBD.
BACKGROUND There is limited and conflicting data available regarding the Cardiovascular disease outcomes associated with Inflammatory Bowel Disease (IBD) OBJECTIVE We aim to perform a systematic review to evaluate the cardiovascular outcomes and mortality associated with IBD patients. METHODS A systematic literature search has been performed on PubMed, Embase, Cochrane, and Scopus from inception till May 2022 without any language restrictions. RESULTS A total of 2,029,941 patients were included into the analysis from 16 studies. The mean age of the patients was 45.6 years. More females were found compared with males (57% vs 43%). The most common risk factors for Cardiovascular disease (CVD) included smoking (24.19%) and alcohol (4.60%). The most common co-morbidities included hypertension (30%), diabetes mellitus (14.41%), dyslipidemia (18.42%), previous CVD (22%), and renal disease (10%). Among outcomes All-cause mortality among IBD patients was 1.66%; Ulcerative Colitis (UC): 15.92%; and Crohn’s disease (CD): 0.30%. Myocardial Infarction (MI) among IBD patients were 1.47%, among UC: 30.96%; and among CD: 34.14%. Cardiovascular Death (CVD) events among IBD patients were 1.95%. Heart failure events among IBD patients were 5.49%, while Stroke events among IBD Patients were 0.95%; among UC: 2.63%; and CD: 2.41% respectively. CONCLUSION There was a possible association between IBD patients and adverse cardiovascular outcomes especially in young and females. Though there remains a lack of concrete treatment algorithms and assessment parameters that better characterize IBD risk factors, nutritional modifications and physical activity should be at the fore-front of CVD prevention in IBD.
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