tetano
Editor, Senior Moderator
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[SUP] 1 2 [/SUP], Prabjot Sehmi[SUP] 3 [/SUP], Beryl Ominde[SUP] 4 [/SUP], Paul Bundi[SUP] 5 [/SUP], Musa Mislani[SUP] 3 [/SUP], Brian Ngure[SUP] 3 [/SUP], Beda Olabu[SUP] 3 [/SUP], Julius A Ogeng'o[SUP] 3 [/SUP]
Affiliations
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 (I[SUP]2[/SUP] = 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.
. 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[SUP] 1 2 [/SUP], Prabjot Sehmi[SUP] 3 [/SUP], Beryl Ominde[SUP] 4 [/SUP], Paul Bundi[SUP] 5 [/SUP], Musa Mislani[SUP] 3 [/SUP], Brian Ngure[SUP] 3 [/SUP], Beda Olabu[SUP] 3 [/SUP], Julius A Ogeng'o[SUP] 3 [/SUP]
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 (I[SUP]2[/SUP] = 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.