Sinus venous thrombosis as a complication of COVID-19-associated hypercoagulability

Abstract

Sinus venous thrombosis (SVT) is an increasingly recognised complication of not only SARS-CoV-2 infections, but also of SARS-CoV-2 vaccinations. SVT is attributed to hypercoagulability, a common complication of COVID-19, disregarding the severity of the infection. Hypercoagulability in COVID-19 is explained by direct activation of platelets, enhancing coagulation, by direct infection and indirect activation of endothelial cells by SARS-CoV-2, shifting endothelial cells from an anti-thrombotic to a pro-thrombotic state, by direct activation of complement pathways, promoting thrombin generation, or by immune thrombocytopenia, which also generates a thrombogenic state. Since SVT may occur even in anticoagulated COVID-19 patients and may have an unfavourable outcome, all efforts must be made to prevent this complication or to treat it accurately.

COVID-19, neurovascular thrombotic problem and short summary on blood coagulation disorder: a brief review

“…Sinus venous thrombosis a possible complication of COVID-19-associated hypercoagulability [ 1 ]. Zarrouk and Finsterer noted that sinus venous thrombosis was a complication of COVID-19- associated hypercoagulability [ 2 ]. Roushdy and Hamid mentioned that alteration of ACE 2 expression might result in hypoxemia, excessive blood pressure rise and volume overload that cause stroke [ 6 ].…”

“…COVID-19 can manifest several atypical clinical presentations including neurological presentation [ 1 ]. An important neurological problem is neurovascular thrombotic disorder [ 2 – 5 ]. A thrombotic event might be due to arterial or venous system affection.…”

“…In a recent publication, Roushdy and Hamid mentioned for the disturbance in renin angiotensin system, angiotensin-converting enzyme (ACE) 2 receptors downregulation, endothelial cell damage, coagulopathy, cytokine storm, and platelet abnormality as underlying factors inducing abnormality in coagulation system [ 6 ]. The coagulation problem might affect several organs including neurological system [ 2 – 5 ]. In this brief review, the authors summarize on venous and arterial neurovascular system thrombotic disorder which is a possible complication of COVID-19.…”