Abstract 294: Impact Of COVID‐19 Pandemic On Incidence And Outcome Of Cerebral Venous Sinus Thrombosis: A Nationwide Analysis

Introduction Coagulation pathway activation linked to COVID‐19 predisposes patients to thromboembolic events. The association between cerebral venous sinus thrombosis (CVST) and COVID‐19 has been reported in small retrospective studies and case reports and series.ObjectivesTo examine the incidence of CVST before and during COVID‐19 pandemic and to analyze patients’ demographics and clinical outcome using a nationally representative database. Methods The Nationwide Inpatient Sample (NIS) 2018‐2021 databases were queried for CVST patients. Patients were stratified into cohorts based on COVID‐19 as a primary diagnosis. Demographics, comorbidities, rate of stroke and National Institutes of Health Stroke Scale (NIHSS) score were compared between the two groups. Primary outcomes were in‐hospital mortality, and the rate of favorable hospital outcome defined as discharge to home or acute rehab center. Propensity score matching was used for multivariable analyses. Poisson regression analysis was used to analyze CVST trends between pre‐pandemic (2018‐2019) and pandemic (2020‐2021) time periods. Results Of 37,635 patients with CVST, 385 had COVID‐19 as a primary diagnosis. A higher proportion of patients with COVID‐19 were Black (24.3% vs 16.0%) and Hispanic (20.3% vs 12.3%). The COVID‐19 cohort had a higher mean Elixhauser Comorbidity Score (11.03 vs 8.63, p=0.03) and higher baseline NIHSS score (15.91 vs 6.38, p=0.001). The COVID‐19 group experienced higher rates of in‐hospital mortality (13.0% vs 5.7%, p=0.007) and longer mean length of stay (12.58 vs 8.11 days, p=0.008). A lower proportion of patients had favorable hospital outcome in the COVID‐19 cohort (45.5% vs 57.7%, p=0.031). However, primary outcomes were comparable in adjusted, propensity matched multivariable analyses. Trend analysis showed a significant increase in CVST rates each year from 2018‐2021, with the greatest increase (33%, p<0.001) occurring during the pandemic between 2020 and 2021. Conclusions CVST rates increased during the COVID‐19 pandemic. COVID‐19 related CVST disproportionately affected Black and Hispanic patients and trended towards worse hospital outcomes.