Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records

To inform the public and policy makers, we investigated and compared the risk of cerebral venous sinus thrombosis (CVST) after SARS-Cov-2 vaccination or infection using a national cohort of 2,643,699 individuals aged 17 y and above, alive, and resident in Wales on 1 January 2020 followed up through...

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Main Authors: Columbus Ohaeri, Daniel Rhys Thomas, Jane Salmon, Simon Cottrell, Jane Lyons, Ashley Akbari, Ronan A Lyons, Fatemeh Torabi, Gareth GI Davies, Christopher Williams
Format: Article
Language:English
Published: Taylor & Francis Group 2022-11-01
Series:Human Vaccines & Immunotherapeutics
Subjects:
Online Access:http://dx.doi.org/10.1080/21645515.2022.2127572
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author Columbus Ohaeri
Daniel Rhys Thomas
Jane Salmon
Simon Cottrell
Jane Lyons
Ashley Akbari
Ronan A Lyons
Fatemeh Torabi
Gareth GI Davies
Christopher Williams
author_facet Columbus Ohaeri
Daniel Rhys Thomas
Jane Salmon
Simon Cottrell
Jane Lyons
Ashley Akbari
Ronan A Lyons
Fatemeh Torabi
Gareth GI Davies
Christopher Williams
author_sort Columbus Ohaeri
collection DOAJ
description To inform the public and policy makers, we investigated and compared the risk of cerebral venous sinus thrombosis (CVST) after SARS-Cov-2 vaccination or infection using a national cohort of 2,643,699 individuals aged 17 y and above, alive, and resident in Wales on 1 January 2020 followed up through multiple linked data sources until 28 March 2021. Exposures were first dose of Oxford-ChAdOx1 or Pfizer-BioNTech vaccine or polymerase chain reaction (PCR)-confirmed SARS-Cov-2 infection. The outcome was an incident record of CVST. Hazard ratios (HR) were calculated using multivariable Cox regression, adjusted for confounders. HR from SARS-Cov-2 infection was compared with that for SARS-Cov-2 vaccination. We identified 910,556 (34.4%) records of first SARS-Cov-2 vaccination and 165,862 (6.3%) of SARS-Cov-2 infection. A total of 1,372 CVST events were recorded during the study period, of which 52 (3.8%) and 48 (3.5%) occurred within 28 d after vaccination and infection, respectively. We observed slight non-significant risk of CVST within 28 d of vaccination [aHR: 1.34, 95% CI: 0.95-1.90], which remained after stratifying by vaccine [BNT162b2, aHR: 1.18 (95% CI: 0.63-2.21); ChAdOx1, aHR: 1.40 (95% CI: 0.95-2.05)]. Three times the number of CVST events is observed within 28 d of a positive SARS-Cov-2 test [aHR: 3.02 (95% CI: 2.17-4.21)]. The risk of CVST following SARS-Cov-2 infection is 2.3 times that following SARS-Cov-2 vaccine. This is important information both for those designing COVID-19 vaccination programs and for individuals making their own informed decisions on the risk-benefit of vaccination. This record-linkage approach will be useful in monitoring the safety of future vaccine programs.
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spelling doaj.art-af18a6e87e8c4ae297e0b0dced0f1aba2023-09-26T13:19:09ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2022-11-0118610.1080/21645515.2022.21275722127572Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health recordsColumbus Ohaeri0Daniel Rhys Thomas1Jane Salmon2Simon Cottrell3Jane Lyons4Ashley AkbariRonan A Lyons5Fatemeh Torabi6Gareth GI Davies7Christopher Williams8Public Health WalesPublic Health WalesPublic Health WalesPublic Health WalesSwansea University Medical School, Swansea UniversitySwansea University Medical School, Swansea UniversitySwansea University Medical School, Swansea UniversitySwansea University Medical School, Swansea UniversityPublic Health WalesTo inform the public and policy makers, we investigated and compared the risk of cerebral venous sinus thrombosis (CVST) after SARS-Cov-2 vaccination or infection using a national cohort of 2,643,699 individuals aged 17 y and above, alive, and resident in Wales on 1 January 2020 followed up through multiple linked data sources until 28 March 2021. Exposures were first dose of Oxford-ChAdOx1 or Pfizer-BioNTech vaccine or polymerase chain reaction (PCR)-confirmed SARS-Cov-2 infection. The outcome was an incident record of CVST. Hazard ratios (HR) were calculated using multivariable Cox regression, adjusted for confounders. HR from SARS-Cov-2 infection was compared with that for SARS-Cov-2 vaccination. We identified 910,556 (34.4%) records of first SARS-Cov-2 vaccination and 165,862 (6.3%) of SARS-Cov-2 infection. A total of 1,372 CVST events were recorded during the study period, of which 52 (3.8%) and 48 (3.5%) occurred within 28 d after vaccination and infection, respectively. We observed slight non-significant risk of CVST within 28 d of vaccination [aHR: 1.34, 95% CI: 0.95-1.90], which remained after stratifying by vaccine [BNT162b2, aHR: 1.18 (95% CI: 0.63-2.21); ChAdOx1, aHR: 1.40 (95% CI: 0.95-2.05)]. Three times the number of CVST events is observed within 28 d of a positive SARS-Cov-2 test [aHR: 3.02 (95% CI: 2.17-4.21)]. The risk of CVST following SARS-Cov-2 infection is 2.3 times that following SARS-Cov-2 vaccine. This is important information both for those designing COVID-19 vaccination programs and for individuals making their own informed decisions on the risk-benefit of vaccination. This record-linkage approach will be useful in monitoring the safety of future vaccine programs.http://dx.doi.org/10.1080/21645515.2022.2127572covid19coronavirusvaccinescerebral venous sinus thrombosiscerebral venous thrombosis
spellingShingle Columbus Ohaeri
Daniel Rhys Thomas
Jane Salmon
Simon Cottrell
Jane Lyons
Ashley Akbari
Ronan A Lyons
Fatemeh Torabi
Gareth GI Davies
Christopher Williams
Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records
Human Vaccines & Immunotherapeutics
covid19
coronavirus
vaccines
cerebral venous sinus thrombosis
cerebral venous thrombosis
title Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records
title_full Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records
title_fullStr Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records
title_full_unstemmed Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records
title_short Comparative risk of cerebral venous sinus thrombosis (CVST) following COVID-19 vaccination or infection: A national cohort study using linked electronic health records
title_sort comparative risk of cerebral venous sinus thrombosis cvst following covid 19 vaccination or infection a national cohort study using linked electronic health records
topic covid19
coronavirus
vaccines
cerebral venous sinus thrombosis
cerebral venous thrombosis
url http://dx.doi.org/10.1080/21645515.2022.2127572
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