Impact of COVID vaccination rollout on the use of computed tomography venography for the assessment of cerebral venous sinus thrombosis

J Med Imaging Radiat Oncol. 2021 Dec;65(7):883-887. doi: 10.1111/1754-9485.13345. Epub 2021 Nov 2.

Abstract

Introduction: Cerebral venous sinus thrombosis (CVST) is rare; however, it has been observed in patients with vaccine-induced immune thrombotic thrombocytopaenia syndrome (VITT) following the use of adenovirus vector vaccines against COVID-19. Adverse vaccine effects have been heavily addressed in mainstream media, likely contributing to vaccination anxiety. This study aimed to assess how the vaccine rollout and media coverage has influenced the use of computed tomography venography (CTV) in an acute care setting of a tertiary hospital.

Method: Single-centre retrospective cohort study from 30 March 2021 to 13 June 2021. Direct comparison to same calendar dates in the preceding 3 years.

Results: In 2021, 57 patients received CTV with headache being the reason in 48 (84%) and 40 (70%) had received ChAdOx1 nCov-19 (AstraZeneca COVID-19 vaccination). Only 20 of these patients received CTV after platelets and D-Dimer had returned, and only three patients met existing guidelines for imaging. Zero cases were positive. The number of CTV studies was 5.2 times than in 2020 and 2.7 times the mean number for the 3 preceding years.

Conclusion: The use of CTV in patients with headache has markedly increased at our centre since negatively biased vaccination influence of mainstream media. Headache is a common vaccine-related side effect and VITT is exceptionably rare. With the rates of vaccination increasing in the community, these results highlight the importance of strict adherence to established evidence-based guidelines. Otherwise, critical care capacity, and in particular imaging resources already under pressure will be strained further.

Keywords: AstraZeneca; COVID; CVST; thrombus; vaccine.

MeSH terms

  • COVID-19 Vaccines
  • COVID-19*
  • ChAdOx1 nCoV-19
  • Computed Tomography Angiography
  • Humans
  • Phlebography
  • Retrospective Studies
  • SARS-CoV-2
  • Sinus Thrombosis, Intracranial*
  • Vaccination

Substances

  • COVID-19 Vaccines
  • ChAdOx1 nCoV-19