tetano
Editor, Senior Moderator
J Neurol
. 2023 Feb 23.
doi: 10.1007/s00415-023-11608-2. Online ahead of print.
Patterns of acute ischemic stroke and intracranial hemorrhage in patients with COVID-19 : Results of a retrospective multicenter neuroimaging-based study from three central European countries
Ulf Jensen-Kondering[SUP] 1 2 [/SUP], Christoph J Maurer[SUP] 3 [/SUP], Hanna C B Brudermann[SUP] 4 [/SUP], Marielle Ernst[SUP] 5 [/SUP], Sam Sedaghat[SUP] 6 7 [/SUP], Nils G Margraf[SUP] 8 [/SUP], Thomas Bahmer[SUP] 9 [/SUP], Olav Jansen[SUP] 6 [/SUP], Jawed Nawabi[SUP] 10 11 [/SUP], Estelle Vogt[SUP] 10 [/SUP], Laura Büttner[SUP] 10 [/SUP], Eberhard Siebert[SUP] 12 [/SUP], Michael Bartl[SUP] 13 [/SUP], Volker Maus[SUP] 14 [/SUP], Gregor Werding[SUP] 14 [/SUP], Marc Schlamann[SUP] 15 [/SUP], Nuran Abdullayev[SUP] 15 16 [/SUP], Benjamin Bender[SUP] 17 [/SUP], Vivien Richter[SUP] 17 [/SUP], Annerose Mengel[SUP] 18 [/SUP], Siri Göpel[SUP] 19 [/SUP], Ansgar Berlis[SUP] 3 [/SUP], Astrid Grams[SUP] 20 [/SUP], Valentin Ladenhauf[SUP] 20 [/SUP], Elke R Gizewski[SUP] 20 [/SUP], Philipp Kindl[SUP] 21 [/SUP], Victor Schulze-Zachau[SUP] 22 [/SUP], Marios Psychogios[SUP] 22 [/SUP], Inke R König[SUP] 4 [/SUP], Stefan Sondermann[SUP] 23 [/SUP], Sönke Wallis[SUP] 24 [/SUP], Norbert Brüggemann[SUP] 25 [/SUP], Peter Schramm[SUP] 23 [/SUP], Alexander Neumann[SUP] 23 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019 (COVID-19) is an infection which can affect the central nervous system. In this study, we sought to investigate associations between neuroimaging findings with clinical, demographic, blood and cerebrospinal fluid (CSF) parameters, pre-existing conditions and the severity of acute COVID-19.
Materials and methods: Retrospective multicenter data retrieval from 10 university medical centers in Germany, Switzerland and Austria between February 2020 and September 2021. We included patients with COVID-19, acute neurological symptoms and cranial imaging. We collected demographics, neurological symptoms, COVID-19 severity, results of cranial imaging, blood and CSF parameters during the hospital stay.
Results: 442 patients could be included. COVID-19 severity was mild in 124 (28.1%) patients (moderate n = 134/30.3%, severe n = 43/9.7%, critical n = 141/31.9%). 220 patients (49.8%) presented with respiratory symptoms, 167 (37.8%) presented with neurological symptoms first. Acute ischemic stroke (AIS) was detected in 70 (15.8%), intracranial hemorrhage (IH) in 48 (10.9%) patients. Typical risk factors were associated with AIS; extracorporeal membrane oxygenation therapy and invasive ventilation with IH. No association was found between the severity of COVID-19 or blood/CSF parameters and the occurrence of AIS or IH.
Discussion: AIS was the most common finding on cranial imaging. IH was more prevalent than expected but a less common finding than AIS. Patients with IH had a distinct clinical profile compared to patients with AIS. There was no association between AIS or IH and the severity of COVID-19. A considerable proportion of patients presented with neurological symptoms first. Laboratory parameters have limited value as a screening tool.
Keywords: Acute ischemic stroke; COVID-19; Intracranial hemorrhage; Neuroimaging.
. 2023 Feb 23.
doi: 10.1007/s00415-023-11608-2. Online ahead of print.
Patterns of acute ischemic stroke and intracranial hemorrhage in patients with COVID-19 : Results of a retrospective multicenter neuroimaging-based study from three central European countries
Ulf Jensen-Kondering[SUP] 1 2 [/SUP], Christoph J Maurer[SUP] 3 [/SUP], Hanna C B Brudermann[SUP] 4 [/SUP], Marielle Ernst[SUP] 5 [/SUP], Sam Sedaghat[SUP] 6 7 [/SUP], Nils G Margraf[SUP] 8 [/SUP], Thomas Bahmer[SUP] 9 [/SUP], Olav Jansen[SUP] 6 [/SUP], Jawed Nawabi[SUP] 10 11 [/SUP], Estelle Vogt[SUP] 10 [/SUP], Laura Büttner[SUP] 10 [/SUP], Eberhard Siebert[SUP] 12 [/SUP], Michael Bartl[SUP] 13 [/SUP], Volker Maus[SUP] 14 [/SUP], Gregor Werding[SUP] 14 [/SUP], Marc Schlamann[SUP] 15 [/SUP], Nuran Abdullayev[SUP] 15 16 [/SUP], Benjamin Bender[SUP] 17 [/SUP], Vivien Richter[SUP] 17 [/SUP], Annerose Mengel[SUP] 18 [/SUP], Siri Göpel[SUP] 19 [/SUP], Ansgar Berlis[SUP] 3 [/SUP], Astrid Grams[SUP] 20 [/SUP], Valentin Ladenhauf[SUP] 20 [/SUP], Elke R Gizewski[SUP] 20 [/SUP], Philipp Kindl[SUP] 21 [/SUP], Victor Schulze-Zachau[SUP] 22 [/SUP], Marios Psychogios[SUP] 22 [/SUP], Inke R König[SUP] 4 [/SUP], Stefan Sondermann[SUP] 23 [/SUP], Sönke Wallis[SUP] 24 [/SUP], Norbert Brüggemann[SUP] 25 [/SUP], Peter Schramm[SUP] 23 [/SUP], Alexander Neumann[SUP] 23 [/SUP]
Affiliations
- PMID: 36820915
- DOI: 10.1007/s00415-023-11608-2
Abstract
Background: Coronavirus disease 2019 (COVID-19) is an infection which can affect the central nervous system. In this study, we sought to investigate associations between neuroimaging findings with clinical, demographic, blood and cerebrospinal fluid (CSF) parameters, pre-existing conditions and the severity of acute COVID-19.
Materials and methods: Retrospective multicenter data retrieval from 10 university medical centers in Germany, Switzerland and Austria between February 2020 and September 2021. We included patients with COVID-19, acute neurological symptoms and cranial imaging. We collected demographics, neurological symptoms, COVID-19 severity, results of cranial imaging, blood and CSF parameters during the hospital stay.
Results: 442 patients could be included. COVID-19 severity was mild in 124 (28.1%) patients (moderate n = 134/30.3%, severe n = 43/9.7%, critical n = 141/31.9%). 220 patients (49.8%) presented with respiratory symptoms, 167 (37.8%) presented with neurological symptoms first. Acute ischemic stroke (AIS) was detected in 70 (15.8%), intracranial hemorrhage (IH) in 48 (10.9%) patients. Typical risk factors were associated with AIS; extracorporeal membrane oxygenation therapy and invasive ventilation with IH. No association was found between the severity of COVID-19 or blood/CSF parameters and the occurrence of AIS or IH.
Discussion: AIS was the most common finding on cranial imaging. IH was more prevalent than expected but a less common finding than AIS. Patients with IH had a distinct clinical profile compared to patients with AIS. There was no association between AIS or IH and the severity of COVID-19. A considerable proportion of patients presented with neurological symptoms first. Laboratory parameters have limited value as a screening tool.
Keywords: Acute ischemic stroke; COVID-19; Intracranial hemorrhage; Neuroimaging.