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 nan 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 Cerebral Venous Sinus Thrombosis in COVID-19 Patients: A Multicenter Study and Review of Literature Endothelial cell infection and endotheliitis in COVID-19 Elevated lipoprotein(a) as a new risk factor of cerebral venous sinus thrombosis: association with fibrin clot properties Lipoprotein(a) and Its Potential Association with Thrombosis and Inflammation in COVID-19: a Testable Hypothesis Familial hypercholesterolemia and elevated lipoprotein(a): double heritable risk and new therapeutic opportunities Impairment of endothelium-dependent dilation is an early event in children with familial hypercholesterolemia and is related to the lipoprotein(a) level Familial hypercholesterolaemia and COVID-19: A two-hit scenario for endothelial dysfunction amenable to treatment World Heath Organization 2021. Statement of the WHO Global Advisory Committee on Vaccine Safety (GACVS) COVID-19 subcommittee on safety signals related to the AstraZeneca COVID-19 vaccine