Intracranial Hemorrhage in COVID-19 Patients

被引:17
作者
Mishra, Sanskriti [1 ,5 ]
Choueka, Murray [5 ]
Wang, Qiang [5 ]
Hu, Chloe [1 ]
Visone, Stephanie [1 ]
Silver, Michael [4 ]
Stein, Evan G. [3 ]
Levine, Steven R. [1 ,5 ,6 ,7 ]
Wang, Qingliang T. [1 ,2 ,3 ,5 ]
机构
[1] Maimonides Hosp, Comprehens Stroke Ctr, Dept Neurol, 948 48th St,2nd Fl, Brooklyn, NY 11219 USA
[2] Maimonides Hosp, Dept Surg, Div Neurosurg, Brooklyn, NY 11219 USA
[3] Maimonides Hosp, Dept Radiol, Brooklyn, NY 11219 USA
[4] Maimonides Hosp, Dept Res Adm, Brooklyn, NY 11219 USA
[5] SUNY Downstate Hlth Sci Univ, Dept Neurol & Stroke Ctr, Brooklyn, NY USA
[6] SUNY Downstate Hlth Sci Univ, Dept Emergency Med, Brooklyn, NY USA
[7] Kings Cty Hosp Ctr, Dept Neurol, Brooklyn, NY USA
基金
英国科研创新办公室;
关键词
COVID-19; Intracranial Hemorrhage; Subarachnoid hemorrhage; & nbsp; Intracerebral Hemorrhage; Hemorrhagic Stroke; BLOOD-PRESSURE VARIABILITY; INTRACEREBRAL HEMORRHAGE; RISK-FACTORS; CLINICAL CHARACTERISTICS; SINGLE-CENTER; INFECTION; STROKE;
D O I
10.1016/j.jstrokecerebrovasdis.2021.105603
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Objective: To describe the clinical, laboratory, temporal, radiographic, and outcome features of acute Intracranial Hemorrhage (ICH) in COVID-19 patients. Methods: Retrospective, observational, consecutive case series of patients admitted with ICH to Maimonides Medical Center from March 1 through July 31, 2020, who had confirmed or highly suspected COVID-19. Demographic, clinical, laboratory, imaging, and outcome data were analyzed. ICH rates among all strokes were compared to the same time period in 2019 in two-week time intervals. Correlation of systolic blood pressure variability (SBPV) and neutrophil-to-lymphocyte ratio (NLR) to clinical outcomes were performed. Results: Of 324 patients who presented with stroke, 65 (20%) were diagnosed with non-traumatic ICH: 8 had confirmed and 3 had highly suspected COVID-19. Nine (82%) had at least one associated risk factor for ICH. Three ICHs occurred during inpatient anticoagulation. More than half (6) suffered either deep or cerebellar hemorrhages; only 2 were lobar hemorrhages. Two of 8 patients with severe pneumonia survived. During the NYC COVID-19 peak period in April, ICH comprised the highest percentage of all strokes (40%), and then steadily decreased week-after-week (p = 0.02). SBPV and NLR were moderately and weakly positively correlated to discharge modified Rankin Scale, respectively. Conclusions: COVID-19 associated ICH is often associated with at least one known ICH risk factor and severe pneumonia. There was a suggestive relative surge in ICH among all stroke types during the first peak of the NYC pandemic. It is important to be vigilant of ICH as a possible and important manifestation of COVID-19.
引用
收藏
页数:10
相关论文
共 47 条
[1]  
Ai T, 2019, Radiology, DOI [10.1148/radiol.2020200642, 10.26434/chemrxiv.11860137.v1, DOI 10.1148/RADIOL.2020200642]
[2]   Spontaneous intracranial hemorrhage in a patient with Middle East respiratory syndrome corona virus [J].
Al-Hameed, Fahad M. .
SAUDI MEDICAL JOURNAL, 2017, 38 (02) :196-200
[3]   COVID-19-associated meningoencephalitis complicated with intracranial hemorrhage: a case report [J].
Al-olama, Mohammad ;
Rashid, Anas ;
Garozzo, Debora .
ACTA NEUROCHIRURGICA, 2020, 162 (07) :1495-1499
[4]   COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection [J].
Al-Samkari, Hanny ;
Leaf, Rebecca S. Karp ;
Dzik, Walter H. ;
Carlson, Jonathan C. T. ;
Fogerty, Annemarie E. ;
Waheed, Anem ;
Goodarzi, Katayoon ;
Bendapudi, Pavan K. ;
Bornikova, Larissa ;
Gupta, Shruti ;
Leaf, David E. ;
Kuter, David J. ;
Rosovsky, Rachel P. .
BLOOD, 2020, 136 (04) :489-500
[5]  
Andalib S, J STROKE CEREBROVASC
[6]  
[Anonymous], Public COVID-19 Data for Norway (covid19data.no). COVID-19 data
[7]   Risk factors for intracerebral hemorrhage in the general population - A systematic review [J].
Ariesen, MJ ;
Claus, SP ;
Rinkel, GJE ;
Algra, A .
STROKE, 2003, 34 (08) :2060-2065
[8]   Intracerebral haemorrhage and COVID-19: Clinical characteristics from a case series [J].
Benger, Matthew ;
Williams, Owain ;
Siddiqui, Juveria ;
Sztriha, Laszlo .
BRAIN BEHAVIOR AND IMMUNITY, 2020, 88 :940-944
[9]   Characteristics of ischaemic stroke associated with COVID-19 [J].
Beyrouti, Rahma ;
Adams, Matthew E. ;
Benjamin, Laura ;
Cohen, Hannah ;
Farmer, Simon F. ;
Goh, Yee Yen ;
Humphries, Fiona ;
Jager, Hans Rolf ;
Losseff, Nicholas A. ;
Perry, Richard J. ;
Shah, Sachit ;
Simister, Robert J. ;
Turner, David ;
Chandratheva, Arvind ;
Werring, David J. .
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 2020, 91 (08) :889-891
[10]   Neutrophil to Lymphocyte Ratio Predicts Poor Prognosis in Ischemic Cerebrovascular Disease [J].
Celikbilek, Asuman ;
Ismailogullari, Sevda ;
Zararsiz, Gokmen .
JOURNAL OF CLINICAL LABORATORY ANALYSIS, 2014, 28 (01) :27-31