Neurol Sci . Intracranial hemorrhage in coronavirus disease 2019 (COVID-19) patients

[tetano]

Neurol Sci


. 2020 Nov 3.
doi: 10.1007/s10072-020-04870-z. Online ahead of print.
Intracranial hemorrhage in coronavirus disease 2019 (COVID-19) patients


Isaac Cheruiyot ^{1 2} , Prabjot Sehmi ³ , Beryl Ominde ⁴ , Paul Bundi ⁵ , Musa Mislani ³ , Brian Ngure ³ , Beda Olabu ³ , Julius A Ogeng'o ³



Affiliations

• PMID: 33140308
• DOI: 10.1007/s10072-020-04870-z

Abstract

Background: Emerging evidence suggests that a subset of coronavirus disease 2019 (COVID-19) patients may present with or develop cerebrovascular disease during the course of hospitalization. Whereas ischemic stroke in COVID-19 patients has been well described, data on intracranial hemorrhage (ICH) in these patients is still limited. We, therefore, conducted a rapid systematic review of current scientific literature to identify and consolidate evidence of ICH in COVID-19 patients.
Methods: A systematic search of literature was conducted between November 1, 2019, and August 14, 2020, on PubMed and China National Knowledge Infrastructure (CNKI) to identify eligible studies.
Results: A total of 23 studies describing ICH in 148 COVID-19 patients were included. The pooled incidence of ICH in COVID-19 patients was 0.7% (95% CI 0.5-0.9), with low levels of inter-study heterogeneity observed (I² = 33.6%, Cochran's Q = 12.05, p = 0.149). Most of the patients were elderly male patients (65.8%) with comorbidities, the most common being systemic hypertension (54%). Hemorrhage involving multiple cranial compartments was reported in 9.5% of cases. Single compartments were involved in the rest, with intraparenchymal hemorrhage (IPH) being the most common variety (62.6%) and intraventricular hemorrhage (IVH) the least common (1.4%). Half of these patients were on some form of anticoagulation. Overall, the mortality rate in the COVID-19 patients with ICH was about 48.6%.
Conclusion: Although relatively uncommon among COVID-19 patients, ICH is associated with a high mortality rate. Early identification of patients at risk of developing ICH, particularly with comorbid conditions and on anticoagulant therapy, may be important to improve outcomes.

Keywords: COVID-19; Hemorrhagic stroke; Intracranial hemorrhage.