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Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage

Background and Purpose: Intracranial hemorrhage has been observed in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19), but the clinical, imaging, and pathophysiological features of intracranial bleeding during COVID-19 infection remain poorly characteri...

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Autores principales: Nawabi, Jawed, Morotti, Andrea, Wildgruber, Moritz, Boulouis, Gregoire, Kraehling, Hermann, Schlunk, Frieder, Can, Elif, Kniep, Helge, Thomalla, Götz, Psychogios, Marios, Hamm, Bernd, Fiehler, Jens, Hanning, Uta, Sporns, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464657/
https://www.ncbi.nlm.nih.gov/pubmed/32781623
http://dx.doi.org/10.3390/jcm9082543
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author Nawabi, Jawed
Morotti, Andrea
Wildgruber, Moritz
Boulouis, Gregoire
Kraehling, Hermann
Schlunk, Frieder
Can, Elif
Kniep, Helge
Thomalla, Götz
Psychogios, Marios
Hamm, Bernd
Fiehler, Jens
Hanning, Uta
Sporns, Peter
author_facet Nawabi, Jawed
Morotti, Andrea
Wildgruber, Moritz
Boulouis, Gregoire
Kraehling, Hermann
Schlunk, Frieder
Can, Elif
Kniep, Helge
Thomalla, Götz
Psychogios, Marios
Hamm, Bernd
Fiehler, Jens
Hanning, Uta
Sporns, Peter
author_sort Nawabi, Jawed
collection PubMed
description Background and Purpose: Intracranial hemorrhage has been observed in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19), but the clinical, imaging, and pathophysiological features of intracranial bleeding during COVID-19 infection remain poorly characterized. This study describes clinical and imaging characteristics of patients with COVID-19 infection who presented with intracranial bleeding in a European multicenter cohort. Methods: This is a multicenter retrospective, observational case series including 18 consecutive patients with COVID-19 infection and intracranial hemorrhage. Data were collected from February to May 2020 at five designated European special care centers for COVID-19. The diagnosis of COVID-19 was based on laboratory-confirmed diagnosis of SARS-CoV-2. Intracranial bleeding was diagnosed on computed tomography (CT) of the brain within one month of the date of COVID-19 diagnosis. The clinical, laboratory, radiologic, and pathologic findings, therapy and outcomes in COVID-19 patients presenting with intracranial bleeding were analyzed. Results: Eighteen patients had evidence of acute intracranial bleeding within 11 days (IQR 9–29) of admission. Six patients had parenchymal hemorrhage (33.3%), 11 had subarachnoid hemorrhage (SAH) (61.1%), and one patient had subdural hemorrhage (5.6%). Three patients presented with intraventricular hemorrhage (IVH) (16.7%). Conclusion: This study represents the largest case series of patients with intracranial hemorrhage diagnosed with COVID-19 based on key European countries with geospatial hotspots of SARS-CoV-2. Isolated SAH along the convexity may be a predominant bleeding manifestation and may occur in a late temporal course of severe COVID-19.
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spelling pubmed-74646572020-09-04 Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage Nawabi, Jawed Morotti, Andrea Wildgruber, Moritz Boulouis, Gregoire Kraehling, Hermann Schlunk, Frieder Can, Elif Kniep, Helge Thomalla, Götz Psychogios, Marios Hamm, Bernd Fiehler, Jens Hanning, Uta Sporns, Peter J Clin Med Article Background and Purpose: Intracranial hemorrhage has been observed in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19), but the clinical, imaging, and pathophysiological features of intracranial bleeding during COVID-19 infection remain poorly characterized. This study describes clinical and imaging characteristics of patients with COVID-19 infection who presented with intracranial bleeding in a European multicenter cohort. Methods: This is a multicenter retrospective, observational case series including 18 consecutive patients with COVID-19 infection and intracranial hemorrhage. Data were collected from February to May 2020 at five designated European special care centers for COVID-19. The diagnosis of COVID-19 was based on laboratory-confirmed diagnosis of SARS-CoV-2. Intracranial bleeding was diagnosed on computed tomography (CT) of the brain within one month of the date of COVID-19 diagnosis. The clinical, laboratory, radiologic, and pathologic findings, therapy and outcomes in COVID-19 patients presenting with intracranial bleeding were analyzed. Results: Eighteen patients had evidence of acute intracranial bleeding within 11 days (IQR 9–29) of admission. Six patients had parenchymal hemorrhage (33.3%), 11 had subarachnoid hemorrhage (SAH) (61.1%), and one patient had subdural hemorrhage (5.6%). Three patients presented with intraventricular hemorrhage (IVH) (16.7%). Conclusion: This study represents the largest case series of patients with intracranial hemorrhage diagnosed with COVID-19 based on key European countries with geospatial hotspots of SARS-CoV-2. Isolated SAH along the convexity may be a predominant bleeding manifestation and may occur in a late temporal course of severe COVID-19. MDPI 2020-08-06 /pmc/articles/PMC7464657/ /pubmed/32781623 http://dx.doi.org/10.3390/jcm9082543 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Nawabi, Jawed
Morotti, Andrea
Wildgruber, Moritz
Boulouis, Gregoire
Kraehling, Hermann
Schlunk, Frieder
Can, Elif
Kniep, Helge
Thomalla, Götz
Psychogios, Marios
Hamm, Bernd
Fiehler, Jens
Hanning, Uta
Sporns, Peter
Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage
title Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage
title_full Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage
title_fullStr Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage
title_full_unstemmed Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage
title_short Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage
title_sort clinical and imaging characteristics in patients with sars-cov-2 infection and acute intracranial hemorrhage
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7464657/
https://www.ncbi.nlm.nih.gov/pubmed/32781623
http://dx.doi.org/10.3390/jcm9082543
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