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SARS-CoV-2 infection is associated with hypercoaguability. We sought to evaluate the demographic and clinical characteristics of CVT among patients hospitalized for COVID-19 at six tertiary care centers in the New York City metropolitan area.

We conducted a retrospective multicenter cohort study of 13,500 consecutive COVID-19 patients who were hospitalized between March 1st, 2020 and May 30th, 2020.

Out of 13,500 COVID-19 patients, 12 had imaging proven CVT with an incidence of 8.8 per 10,000 over 3 months which is significantly higher than the reported incidence of CVT in the general population of 5 per million annually. There was a male preponderance (8 men, 4 women) and an average age of 49 years (95% CI 36-62, range of 17-95).  Only one patient (8%) had a prior history of thromboembolic disease.  Neurologic symptoms secondary to CVT occurred within 24 hours of the onset of the respiratory and constitutional symptoms in 58% of cases, and 75% had venous infarction, hemorrhage, or both on brain imaging.  Management consisted of anticoagulation, endovascular thrombectomy, and surgical hematoma evacuation. The mortality rate was 25%.

Early evidence suggests a higher than expected frequency of CVT among patients hospitalized for COVID-19.  CVT should be included in the differential diagnosis of neurological syndromes associated with SARS-CoV-2 infection.