Abstract TP113: Cerebral Venous Thrombosis during the COVID-19 pandemic: Insights from the National Inpatient Sample.

Background: COVID-19 has been associated with higher incidence of system venous and arterial thrombosis. We previously identified higher incidence of CVT during the first year of the COVID-19 pandemic in a nationally representative dataset and sought to determine if this was consistent during later pandemic years. The objective of the current study was to evaluate trends in CVT incidence prior to and during the COVID-19 pandemic. Methods: A cross-sectional study utilizing data from the National Inpatient Sample (NIS) was performed. Adult patients from 2016-2018 were compared to those in 2020-2022. Patients in 2019 were excluded from this comparison to avoid potential confounding from undiagnosed COVID-19. ICD-10 codes were utilized to identify patients with CVT along with additional diagnoses, including COVID-19 infection. Odds ratios and 95% confidence intervals were calculated to examine differences in pre- and during-pandemic CVT incidence and comorbid conditions. Rates of CVT were also calculated for each year (2016-2022). All analyses were completed in SAS 9.4. Results: There were 1,784 (weighted estimate for the US population n = 8,920) patients with CVT during the COVID-19 years, compared to 1,158 patients (weighted n = 5,790) during the pre-COVID-19 years. Yearly rates per 100,000 discharges are presented in Figure 1. While CVT rates have risen slightly year over year, the odds of having a CVT were higher in the COVID-19 years compared to pre-COVID-19 years (OR = 1.67, 95% CI = 1.51-1.86). Of the 1,220,819 COVID-19 diagnoses reported between 2020-2022, only 90 (0.01%) of them were also diagnosed with CVT. However, CVT patients with concurrent COVID-19 had a longer hospital stay than those without COVID-19 [14.3 (sd=16.4) vs 8.03 (sd=11.4) days; p<0.001]. Conclusion: There has been a steady rise in the recorded incidence of CVT even before the COVID-19 era, with large population studies such as this one showing average annual increases. However, the increasing slope steepened during the pandemic before reaching a plateau. One possible explanation is increased imaging and screening due to heightened vigilance by physicians and a greater public awareness of coagulation related diseases amidst the COVID-19 pandemic.