Intracranial Hemorrhage in Patients with Coronavirus Disease 2019 (COVID-19): A Case Series.
Publication/Presentation Date
10-1-2021
Abstract
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.
Volume
154
First Page
473
Last Page
473
ISSN
1878-8769
Published In/Presented At
Abbas, R., El Naamani, K., Sweid, A., Schaefer, J. W., Bekelis, K., Sourour, N., Elhorany, M., Pandey, A. S., Tjoumakaris, S., Gooch, M. R., Herial, N. A., Rosenwasser, R. H., & Jabbour, P. (2021). Intracranial Hemorrhage in Patients with Coronavirus Disease 2019 (COVID-19): A Case Series. World neurosurgery, 154, e473–e480. https://doi.org/10.1016/j.wneu.2021.07.067
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
34298138
Department(s)
Administration and Leadership
Document Type
Article