Cerebral microhaemorrhage in COVID-19: a critical illness related phenomenon?

Autor: Christopher Coughlan, Brynmor Jones, Pritika Gaur, Dermot Mallon, Francesca Tona, Cillian McNamara, Luke Dixon, Mark Wilson, W. Jan
Jazyk: angličtina
Předmět:
Male
Pediatrics
MICROBLEEDS
INTRACEREBRAL HEMORRHAGE
Disease
Corpus callosum
lcsh:RC346-429
Corpus Callosum
030218 nuclear medicine & medical imaging
0302 clinical medicine
blood flow
Original Research
Middle Aged
Magnetic Resonance Imaging
White Matter
Treatment Outcome
medicine.anatomical_structure
Female
haemorrhage
medicine.symptom
Respiratory Insufficiency
Cardiology and Cardiovascular Medicine
Life Sciences & Biomedicine
MRI
medicine.medical_specialty
brain
Critical Illness
Clinical Neurology
White matter
03 medical and health sciences
medicine
Humans
lcsh:Neurology. Diseases of the nervous system
Aged
Cerebral Hemorrhage
Retrospective Studies
Science & Technology
business.industry
COVID-19
Retrospective cohort study
Hypoxia (medical)
Respiration
Artificial
infection
Respiratory failure
inflammation
Observational study
Neurosciences & Neurology
Neurology (clinical)
Complication
business
SYSTEM
030217 neurology & neurosurgery
Brain Stem
Zdroj: Stroke and Vascular Neurology, Vol, Iss
Stroke and Vascular Neurology
ISSN: 2059-8696
Popis: BackgroundCerebral microhaemorrhages are increasingly being recognised as a complication of COVID-19. This observational retrospective study aims to further investigate the potential pathophysiology through assessing the pattern of microhaemorrhage and clinical characteristics of patients with COVID-19 and microhaemorrhage. By comparing with similar patterns of microhaemorrhage in other non-COVID-19 disease, this study aims to propose possible common pathogenic mechanisms.MethodsA retrospective observational case series was performed identifying all patients with COVID-19 complicated by cerebral microhaemorrhage on MRI. The distribution and number of microhaemorrhages were recorded using the microbleed anatomical scale, and patients’ baseline characteristics and salient test results were also recorded.ResultsCerebral microhaemorrhages were noted to have a predilection for the corpus callosum, the juxtacortical white matter and brainstem. All patients had a preceding period of critical illness with respiratory failure and severe hypoxia necessitating intubation and mechanical ventilation.DiscussionThis study demonstrates a pattern of cerebral microhaemorrhage that is similar to the pattern reported in patients with non-COVID-19 related critical illness and other causes of severe hypoxia. This raises questions regarding whether microhaemorrhage occurs from endothelial dysfunction due the direct effect of SARS-CoV-2 infection or from the secondary effects of critical illness and hypoxia.
Databáze: OpenAIRE
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