key: cord-1051137-fxbp2vfa
authors: Vuorio, Alpo; Kaste, Markku; Kovanen, Petri T.
title: Elevated Lipoprotein(a) and Cerebral Venous Sinus Thrombosis in COVID-19
date: 2021-05-10
journal: J Stroke Cerebrovasc Dis
DOI: 10.1016/j.jstrokecerebrovasdis.2021.105865
sha: 5e3496434abd3c0b3b0d79bcea485b0c922c3bfa
doc_id: 1051137
cord_uid: fxbp2vfa

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We wish to add elevated serum lipoprotein(a) [Lp(a)] to the list of risk factors. Thus, based on a study by Skuza and coworkers 3 in which 80 CVST patients were followed after CVST, recurrence of CVST was found in 12 patients (15%) after a median follow-up time of 26 months. Serum Lp(a) concentrations were higher in the patients with recurrent CVST than those without it, i.e., 28 (19-36) mg/dL vs. 14 (9 -25) mg/dL. The importance of elevated serum Lp(a) as a potential risk factor for CVST maybe even more significant in patients with SARS-Cov-2 infection. The reason for this assumption is the fact that Lp(a) inhibits endogenous fibrinolysis and enhances inflammation thereby causing a procoagulant state. 4 Also, in patients with COVID-19, the disease-associated increased interleukin-6 level induces an elevated serum Lp(a) level which again further increases the risk of thrombosis.

Even though the incidence of CVST is low (about 0.02%) among patients with COVID-19, the figure is still 30 to 60 times greater than that among CVST in patients without SARS-CoV-2 infection. 1 There might be also special groups of COVID-19 patients with a particularly elevated 

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