LAUSR

Study Objectives: Cerebral venous thrombosis (CVT) has garnered attention recently because of reports of cases following COVID-19 vaccine administration. Even before vaccinations began, COVID-19 infection has been shown to be associated with increased incidence of venous thromboembolic diseases. Since CVT is a thromboembolic disease, we hypothesized that the number of ED patients with CVTs increased after the arrival of COVID-19 in the New York City area in early March 2020. Methods: Retrospective cohort design. EDs of 28 hospitals within 150 miles of New York City. Hospitals were teaching or non-teaching and rural, suburban or urban. Annual ED volumes were from 12,000 to 122,000. The database we had available included consecutive patients seen by ED physicians from March through November in 2019 and 2020. We tallied the number of patients diagnosed with CVTs using International Classification of Disease (version 10) codes. Results: The database contained a total of 1,975,332 visits, 1,161,080 in 2019 and 814,252 in 2020 (a 30% decrease from 2019 to 2020). In 2019 six patients were diagnosed with CVT and in 2020, three patients. For these CVT patients, the median age [interquartile range] was 44 [36-50] and 78% were female. Conclusion: Contrary to our hypothesis, we found that after the arrival of COVID-19 in our area, visits for CVTs did not increase. We speculate that total ED visits decreased in 2020 because of public health mandates and fear of contracting COVID-19. The decrease in visits for CVTs that we found may have been due to the overall decrease in ED visits. Another factor may have been that ED testing was reduced to move patients out of the ED expeditiously, to lower the risk of exposing personnel and other patients to infection.