Acute Arterial Ischemic Stroke Following COVID-19 Vaccination
Maria‐Ioanna Stefanou, Lina Palaiodimou, Diana Aguiar de Sousa, Aikaterini Theodorou, Eleni Bakola, Dimitrios Eleftherios Katsaros, Panagiotis Halvatsiotis, Elias Tzavellas, Androniki Naska, Jonathan M. Coutinho, Else Charlotte Sandset, Evangelos J. Giamarellos‐Bourboulis, Georgios Tsivgoulis
Abstract
BACKGROUND AND OBJECTIVES: Acute arterial ischemic stroke (AIS) has been reported as a rare adverse event following coronavirus disease 2019 (COVID-19) vaccination with messenger RNA (mRNA) or viral vector vaccines. However, data are sparse regarding the risk of postvaccination AIS and its potential association with thrombotic-thrombocytopenia syndrome (TTS). METHODS: A systematic review and meta-analysis of randomized controlled clinical trials (RCTs), pharmacovigilance registries, registry-based studies, observational cohorts, and case-series was performed with the aim to calculate the following: (1) the pooled proportion of patients presenting with AIS following COVID-19 vaccination; (2) the prevalence of AIS after mRNA and vector-based vaccination; and (3) the proportion of TTS among postvaccination AIS cases. Patient characteristics were assessed as secondary outcomes. RESULTS: = 78.8%). DISCUSSION: The pooled proportion of AIS following COVID-19 vaccination is comparable with the prevalence of AIS in the general population and much lower than the AIS prevalence among severe acute respiratory syndrome coronavirus 2-infected patients. TTS is very uncommonly reported in patients with AIS following COVID-19 vaccination.