Intracranial Hemorrhage in Patients with Coronavirus Disease 2019 (COVID-19): A Case Series.

Autor: Abbas R; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA., El Naamani K; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA., Sweid A; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA., Schaefer JW; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA., Bekelis K; Department of Neurosurgery, Good Samaritan Hospital Medical Center, West Islip, New York, USA., Sourour N; Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France., Elhorany M; Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France., Pandey AS; Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA., Tjoumakaris S; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA., Gooch MR; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA., Herial NA; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA., Rosenwasser RH; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA., Jabbour P; Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA. Electronic address: pascal.jabbour@jefferson.edu.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2021 Oct; Vol. 154, pp. e473-e480. Date of Electronic Publication: 2021 Jul 21.
DOI: 10.1016/j.wneu.2021.07.067
Abstrakt: Background: The coronavirus disease 2019 (COVID-19) pandemic is an ongoing public health emergency. While most cases end in asymptomatic or minor illness, there is growing evidence that some COVID-19 infections result in nonconventional dire consequences. We sought to describe the characteristics of patients with intracranial hemorrhage who were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Also, with the existing literature, we raise the idea of a possible association between SARS-CoV-2 infection and intracranial hemorrhage and propose possible pathophysiological mechanisms connecting the two.
Methods: We retrospectively collected and analyzed intracranial hemorrhage cases who were also positive for SARS-CoV-2 from 4 tertiary-care cerebrovascular centers.
Results: We identified a total of 19 patients consisting of 11 males (58%) and 8 females (42%). Mean age was 52.2, with 95% younger than 75 years of age. With respect to COVID-19 illness, 50% had mild-to-moderate disease, 21% had severe disease, and 20% had critical disease requiring intubation. Of the 19 cases, 12 patients had intraparenchymal hemorrhage (63%), 6 had subarachnoid hemorrhage (32%), and 1 patient had a subdural hematoma (5%). A total of 43% had an intracerebral hemorrhage score of 0-2 and 57% a score of 3-6. Modified Rankin Scale cores at discharge were 0-2 in 23% and 3-6 in 77%. The mortality rate was 59%.
Conclusions: Our series sheds light on a distinct pattern of intracerebral hemorrhage in COVID-19-positive cases compared with typical non-COVID-19 cases, namely the severity of hemorrhage, high mortality rate, and the young age of patients. Further research is warranted to delineate a potential association between SARS-CoV-2 infection and intracranial hemorrhage.
(Copyright © 2021. Published by Elsevier Inc.)
Databáze: MEDLINE
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