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Intracranial Hemorrhage in Patients with Coronavirus Disease 2019 (COVID-19): A Case Series.
Abbas, Rawad; El Naamani, Kareem; Sweid, Ahmad; Schaefer, Joseph W; Bekelis, Kimon; Sourour, Nader; Elhorany, Mahmoud; Pandey, Aditya S; Tjoumakaris, Stavropoula; Gooch, Michael R; Herial, Nabeel A; Rosenwasser, Robert H; Jabbour, Pascal.
  • 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.
World Neurosurg ; 154: e473-e480, 2021 10.
Article in English | MEDLINE | ID: covidwho-1376112
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Intracranial Hemorrhages / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2021 Document Type: Article Affiliation country: J.wneu.2021.07.067

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Intracranial Hemorrhages / COVID-19 Type of study: Controlled clinical trial / Etiology study / Observational study / Prognostic study / Risk factors Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged / Young adult Language: English Journal: World Neurosurg Journal subject: Neurosurgery Year: 2021 Document Type: Article Affiliation country: J.wneu.2021.07.067