tetano
Editor, Senior Moderator
J Clin Med
. 2022 Jan 25;11(3):605.
doi: 10.3390/jcm11030605.
COVID-19 and Intracranial Hemorrhage: A Multicenter Case Series, Systematic Review and Pooled Analysis
Moritz L Schmidbauer[SUP] 1 [/SUP], Caroline Ferse[SUP] 2 [/SUP], Farid Salih[SUP] 3 [/SUP], Carsten Klingner[SUP] 4 [/SUP], Rita Musleh[SUP] 4 [/SUP], Stefan Kunst[SUP] 1 [/SUP], Matthias Wittstock[SUP] 5 [/SUP], Bernhard Neumann[SUP] 6 7 [/SUP], Karl-Michael Schebesch[SUP] 8 [/SUP], Julian Bösel[SUP] 9 [/SUP], Jana Godau[SUP] 9 [/SUP], Piergiorgio Lochner[SUP] 10 [/SUP], Elisabeth H Adam[SUP] 11 [/SUP], Kolja Jahnke[SUP] 12 [/SUP], Benjamin Knier[SUP] 13 [/SUP], Ingo Schirotzek[SUP] 14 [/SUP], Wolfgang Müllges[SUP] 15 [/SUP], Quirin Notz[SUP] 15 [/SUP], Markus Dengl[SUP] 16 [/SUP], Andreas Güldner[SUP] 17 [/SUP], Oezguer A Onur[SUP] 18 [/SUP], Jorge Garcia Borrega[SUP] 19 [/SUP], Konstantinos Dimitriadis[SUP] 1 20 [/SUP], Albrecht Günther[SUP] 4 [/SUP], On Behalf Of The Ignite Study Group
Affiliations
Abstract
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) profoundly impacts hemostasis and microvasculature. In the light of the dilemma between thromboembolic and hemorrhagic complications, in the present paper, we systematically investigate the prevalence, mortality, radiological subtypes, and clinical characteristics of intracranial hemorrhage (ICH) in coronavirus disease (COVID-19) patients.
Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a systematic review of the literature by screening the PubMed database and included patients diagnosed with COVID-19 and concomitant ICH. We performed a pooled analysis, including a prospectively collected cohort of critically ill COVID-19 patients with ICH, as part of the PANDEMIC registry (Pooled Analysis of Neurologic Disorders Manifesting in Intensive Care of COVID-19).
Results: Our literature review revealed a total of 217 citations. After the selection process, 79 studies and a total of 477 patients were included. The median age was 58.8 years. A total of 23.3% of patients experienced the critical stage of COVID-19, 62.7% of patients were on anticoagulation and 27.5% of the patients received ECMO. The prevalence of ICH was at 0.85% and the mortality at 52.18%, respectively.
Conclusion: ICH in COVID-19 patients is rare, but it has a very poor prognosis. Different subtypes of ICH seen in COVID-19, support the assumption of heterogeneous and multifaceted pathomechanisms contributing to ICH in COVID-19. Further clinical and pathophysiological investigations are warranted to resolve the conflict between thromboembolic and hemorrhagic complications in the future.
Keywords: COVID-19; anticoagulation; intracranial hemorrhage; prognosis.
. 2022 Jan 25;11(3):605.
doi: 10.3390/jcm11030605.
COVID-19 and Intracranial Hemorrhage: A Multicenter Case Series, Systematic Review and Pooled Analysis
Moritz L Schmidbauer[SUP] 1 [/SUP], Caroline Ferse[SUP] 2 [/SUP], Farid Salih[SUP] 3 [/SUP], Carsten Klingner[SUP] 4 [/SUP], Rita Musleh[SUP] 4 [/SUP], Stefan Kunst[SUP] 1 [/SUP], Matthias Wittstock[SUP] 5 [/SUP], Bernhard Neumann[SUP] 6 7 [/SUP], Karl-Michael Schebesch[SUP] 8 [/SUP], Julian Bösel[SUP] 9 [/SUP], Jana Godau[SUP] 9 [/SUP], Piergiorgio Lochner[SUP] 10 [/SUP], Elisabeth H Adam[SUP] 11 [/SUP], Kolja Jahnke[SUP] 12 [/SUP], Benjamin Knier[SUP] 13 [/SUP], Ingo Schirotzek[SUP] 14 [/SUP], Wolfgang Müllges[SUP] 15 [/SUP], Quirin Notz[SUP] 15 [/SUP], Markus Dengl[SUP] 16 [/SUP], Andreas Güldner[SUP] 17 [/SUP], Oezguer A Onur[SUP] 18 [/SUP], Jorge Garcia Borrega[SUP] 19 [/SUP], Konstantinos Dimitriadis[SUP] 1 20 [/SUP], Albrecht Günther[SUP] 4 [/SUP], On Behalf Of The Ignite Study Group
Affiliations
- PMID: 35160057
- DOI: 10.3390/jcm11030605
Abstract
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) profoundly impacts hemostasis and microvasculature. In the light of the dilemma between thromboembolic and hemorrhagic complications, in the present paper, we systematically investigate the prevalence, mortality, radiological subtypes, and clinical characteristics of intracranial hemorrhage (ICH) in coronavirus disease (COVID-19) patients.
Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we performed a systematic review of the literature by screening the PubMed database and included patients diagnosed with COVID-19 and concomitant ICH. We performed a pooled analysis, including a prospectively collected cohort of critically ill COVID-19 patients with ICH, as part of the PANDEMIC registry (Pooled Analysis of Neurologic Disorders Manifesting in Intensive Care of COVID-19).
Results: Our literature review revealed a total of 217 citations. After the selection process, 79 studies and a total of 477 patients were included. The median age was 58.8 years. A total of 23.3% of patients experienced the critical stage of COVID-19, 62.7% of patients were on anticoagulation and 27.5% of the patients received ECMO. The prevalence of ICH was at 0.85% and the mortality at 52.18%, respectively.
Conclusion: ICH in COVID-19 patients is rare, but it has a very poor prognosis. Different subtypes of ICH seen in COVID-19, support the assumption of heterogeneous and multifaceted pathomechanisms contributing to ICH in COVID-19. Further clinical and pathophysiological investigations are warranted to resolve the conflict between thromboembolic and hemorrhagic complications in the future.
Keywords: COVID-19; anticoagulation; intracranial hemorrhage; prognosis.