{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,12,7]],"date-time":"2024-12-07T05:11:25Z","timestamp":1733548285063,"version":"3.30.1"},"reference-count":13,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>During the COVID-19 pandemic, the authors\u2019 institution managed ventriculoatrial (VA) shunt complications in 2 teenage patients in close proximity to a symptomatic COVID-19 infection. Systemic thrombotic events are an established complication of COVID-19 infection due to a hypercoagulable state. Thrombotic complications, particularly elevated central venous pressure, can cause VA shunt failure. The true effect of COVID-19 on patients with intravascular devices is currently unknown. In this study, the authors aimed to determine if there was an association between COVID-19 infection and VA shunt failure.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>TriNetX, an aggregated electronic health record platform, was used to analyze data of more than 13 million US pediatric patients. Two matched cohorts of patients &lt; 18 years of age with a VA shunt were defined. Group 1 (n = 311) had a positive laboratory test for COVID-19 from March 1, 2020, to March 31, 2022. Group 2 (n = 311), a control group, had any medical appointment from March 1, 2020, to March 31, 2022, and never had a positive laboratory test for COVID-19. The authors analyzed outcomes 1 year after testing positive for COVID-19 in group 1, and after the medical appointment in group 2. Outcomes included shunt complications, shunt revisions or replacements, and thromboembolic complications. To protect patient privacy, individual results of fewer than 10 patients are not specified in TriNetX.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Group 1 had a greater odds of mechanical shunt complication than group 2 (20% vs 4%, OR 5.71, 95% CI 3.07\u201310.62). Group 1 had a greater odds of shunt reoperation than group 2 (11% vs &lt; 3%, OR &gt; 3.7, 95% CI 1.72\u20137.62). There were 1\u201310 patients in group 1 (\u2264 3% of group 1) who experienced a thromboembolism due to the shunt, compared with no patients in group 2 who had a thromboembolism due to the shunt.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>This analysis demonstrates an association of shunt complications, reoperations, and thromboembolic events in patients with VA shunts following COVID-19 infection.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.4.peds23517","type":"journal-article","created":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T02:13:49Z","timestamp":1718417629000},"page":"216-220","source":"Crossref","is-referenced-by-count":0,"title":["The association of COVID-19 with increased pediatric ventriculoatrial shunt failures: a national retrospective cohort"],"prefix":"10.3171","volume":"34","author":[{"given":"Uma V.","family":"Mahajan","sequence":"first","affiliation":[{"name":"Departments of Surgery and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Defta","sequence":"additional","affiliation":[{"name":"Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David C.","family":"Kaelber","sequence":"additional","affiliation":[{"name":"Departments of Surgery and"},{"name":"Departments of Internal Medicine,"},{"name":"The Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland;"},{"name":"Pediatrics, and"},{"name":"Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay P.","family":"Ahuja","sequence":"additional","affiliation":[{"name":"Divisions of Pediatric Hematology\/Oncology and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian D.","family":"Rothstein","sequence":"additional","affiliation":[{"name":"Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland;"},{"name":"Pediatric Neurosurgery, Rainbow Babies & Children\u2019s Hospital, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krystal L.","family":"Tomei","sequence":"additional","affiliation":[{"name":"Neurological Surgery, University Hospitals Cleveland Medical Center, Cleveland;"},{"name":"Pediatric Neurosurgery, Rainbow Babies & Children\u2019s Hospital, Cleveland, Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"Childs Nerv Syst","first-page":"2207","article-title":"Reconversion to ventriculoperitoneal shunt following ventriculoatrial shunt malfunction in children","volume":"37","author":"Yamashita S","year":"2021","unstructured":"Yamashita S, Kimiwada T, Hayashi T, Shirane R, Tomonaga T. Reconversion to ventriculoperitoneal shunt following ventriculoatrial shunt malfunction in children. Childs Nerv Syst. 2021;37(7):2207\u20132213."},{"issue":"348","key":"b2","series-title":"World Neurosurg","first-page":"351","article-title":"Cardioversion-responsive ventriculoatrial shunt malfunction precipitated by atrial fibrillation","volume":"114","author":"Kim WJ","year":"2018","unstructured":"Kim WJ, Zenonos G, McDowell MM, Gardner PA, Engh JA. Cardioversion-responsive ventriculoatrial shunt malfunction precipitated by atrial fibrillation. World Neurosurg. 2018;114(348):351."},{"issue":"1","key":"b3","series-title":"Crit Care","first-page":"360","article-title":"The unique characteristics of COVID-19 coagulopathy","volume":"24","author":"Iba T","year":"2020","unstructured":"Iba T, Levy JH, Connors JM, Warkentin TE, Thachil J, Levi M. The unique characteristics of COVID-19 coagulopathy. Crit Care. 2020;24(1):360."},{"issue":"2","key":"b4","series-title":"Blood","first-page":"190","article-title":"Rate of thrombosis in children and adolescents hospitalized with COVID-19 or MIS-C","volume":"138","author":"Whitworth H","year":"2021","unstructured":"Whitworth H, Sartain SE, Kumar R,  Rate of thrombosis in children and adolescents hospitalized with COVID-19 or MIS-C. Blood. 2021;138(2):190\u2013198."},{"key":"b5","series-title":"Respir Med Case Rep","first-page":"101186","article-title":"Insidious development of pulmonary embolism in asymptomatic patients with COVID-19: two rare case-reports","volume":"31","author":"Alharthy A","year":"2020","unstructured":"Alharthy A, Balhamar A, Faqihi F,  Insidious development of pulmonary embolism in asymptomatic patients with COVID-19: two rare case-reports. Respir Med Case Rep. 2020;31101186."},{"issue":"3","key":"b6","series-title":"Clin Pract Cases Emerg Med","first-page":"295","article-title":"Patients with mild COVID-19 symptoms and coincident pulmonary embolism: a case series","volume":"4","author":"Joseph JW","year":"2020","unstructured":"Joseph JW, Roberts JC, Weaver CN, Anderson JS, Wong ML. Patients with mild COVID-19 symptoms and coincident pulmonary embolism: a case series. Clin Pract Cases Emerg Med. 2020;4(3):295\u2013298."},{"issue":"8","key":"b7","series-title":"Clin Infect Dis","first-page":"1500","article-title":"Cardiovascular outcomes after tixagevimab and cilgavimab use for pre-exposure prophylaxis against COVID-19: a population-based propensity-matched cohort study","volume":"76","author":"Birabaharan M","year":"2023","unstructured":"Birabaharan M, Hill E, Begur M, Kaelber DC, Martin TC, Mehta SR. Cardiovascular outcomes after tixagevimab and cilgavimab use for pre-exposure prophylaxis against COVID-19: a population-based propensity-matched cohort study. Clin Infect Dis. 2023;76(8):1500\u20131503."},{"issue":"2","key":"b8","series-title":"Mol Psychiatry","first-page":"543","article-title":"Association of COVID-19 with endocarditis in patients with cocaine or opioid use disorders in the US","volume":"28","author":"Wang L","year":"2023","unstructured":"Wang L, Volkow ND, Berger NA, Davis PB, Kaelber DC, Xu R. Association of COVID-19 with endocarditis in patients with cocaine or opioid use disorders in the US. Mol Psychiatry. 2023;28(2):543\u2013552."},{"issue":"305","key":"b9","series-title":"J Pediatr","first-page":"314","article-title":"Pulmonary vascular changes complicating ventriculovascular shunting for hydrocephalus","volume":"64","author":"Friedman S","year":"1964","unstructured":"Friedman S, Zita-Gozum C, Chatten J. Pulmonary vascular changes complicating ventriculovascular shunting for hydrocephalus. J Pediatr. 1964;64(305):314."},{"issue":"2","key":"b10","series-title":"Neurosurg Rev","first-page":"1111","article-title":"Thrombosis associated with ventriculoatrial shunts","volume":"45","author":"Wu D","year":"2022","unstructured":"Wu D, Guan Z, Xiao L, Li D. Thrombosis associated with ventriculoatrial shunts. Neurosurg Rev. 2022;45(2):1111\u20131122."},{"issue":"12","key":"b11","series-title":"Thromb Haemost","first-page":"1668","article-title":"Coagulopathy and thrombosis as a result of severe COVID-19 infection: a microvascular focus","volume":"120","author":"Katneni UK","year":"2020","unstructured":"Katneni UK, Alexaki A, Hunt RC,  Coagulopathy and thrombosis as a result of severe COVID-19 infection: a microvascular focus. Thromb Haemost. 2020;120(12):1668\u20131679."},{"issue":"4","key":"b12","series-title":"Ann Intern Med","first-page":"268","article-title":"Autopsy findings and venous thromboembolism in patients with COVID-19: a prospective cohort study","volume":"173","author":"Wichmann D","year":"2020","unstructured":"Wichmann D, Sperhake JP, L\u00fctgehetmann M,  Autopsy findings and venous thromboembolism in patients with COVID-19: a prospective cohort study. 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J Thromb Haemost. 2020;18(11):3099\u20133105."}],"container-title":["Journal of Neurosurgery: Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/34\/3\/article-p216.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/34\/3\/article-p216.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-pediatr\/34\/3\/article-p216.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:07:04Z","timestamp":1733490424000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-pediatr\/34\/3\/article-p216.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,1]]},"references-count":13,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2024.4.peds23517","relation":{},"ISSN":["1933-0707","1933-0715"],"issn-type":[{"type":"print","value":"1933-0707"},{"type":"electronic","value":"1933-0715"}],"subject":[],"published":{"date-parts":[[2024,9,1]]}}}