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Intracranial Hemorrhage in COVID-19 Patients
OBJECTIVE: To describe the clinical, laboratory, temporal, radiographic, and outcome features of acute Intracranial Hemorrhage (ICH) in COVID-19 patients. METHODS: Retrospective, observational, consecutive case series of patients admitted with ICH to Maimonides Medical Center from March 1 through Ju...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831866/ https://www.ncbi.nlm.nih.gov/pubmed/33484980 http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.105603 |
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author | Mishra, Sanskriti Choueka, Murray Wang, Qiang Hu, Chloe Visone, Stephanie Silver, Michael Stein, Evan G. Levine, Steven R. Wang, Qingliang T. |
author_facet | Mishra, Sanskriti Choueka, Murray Wang, Qiang Hu, Chloe Visone, Stephanie Silver, Michael Stein, Evan G. Levine, Steven R. Wang, Qingliang T. |
author_sort | Mishra, Sanskriti |
collection | PubMed |
description | OBJECTIVE: To describe the clinical, laboratory, temporal, radiographic, and outcome features of acute Intracranial Hemorrhage (ICH) in COVID-19 patients. METHODS: Retrospective, observational, consecutive case series of patients admitted with ICH to Maimonides Medical Center from March 1 through July 31, 2020, who had confirmed or highly suspected COVID-19. Demographic, clinical, laboratory, imaging, and outcome data were analyzed. ICH rates among all strokes were compared to the same time period in 2019 in two-week time intervals. Correlation of systolic blood pressure variability (SBPV) and neutrophil-to-lymphocyte ratio (NLR) to clinical outcomes were performed. RESULTS: Of 324 patients who presented with stroke, 65 (20%) were diagnosed with non-traumatic ICH: 8 had confirmed and 3 had highly suspected COVID-19. Nine (82%) had at least one associated risk factor for ICH. Three ICHs occurred during inpatient anticoagulation. More than half (6) suffered either deep or cerebellar hemorrhages; only 2 were lobar hemorrhages. Two of 8 patients with severe pneumonia survived. During the NYC COVID-19 peak period in April, ICH comprised the highest percentage of all strokes (40%), and then steadily decreased week-after-week (p = 0.02). SBPV and NLR were moderately and weakly positively correlated to discharge modified Rankin Scale, respectively. CONCLUSIONS: COVID-19 associated ICH is often associated with at least one known ICH risk factor and severe pneumonia. There was a suggestive relative surge in ICH among all stroke types during the first peak of the NYC pandemic. It is important to be vigilant of ICH as a possible and important manifestation of COVID-19. |
format | Online Article Text |
id | pubmed-7831866 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78318662021-01-26 Intracranial Hemorrhage in COVID-19 Patients Mishra, Sanskriti Choueka, Murray Wang, Qiang Hu, Chloe Visone, Stephanie Silver, Michael Stein, Evan G. Levine, Steven R. Wang, Qingliang T. J Stroke Cerebrovasc Dis Article OBJECTIVE: To describe the clinical, laboratory, temporal, radiographic, and outcome features of acute Intracranial Hemorrhage (ICH) in COVID-19 patients. METHODS: Retrospective, observational, consecutive case series of patients admitted with ICH to Maimonides Medical Center from March 1 through July 31, 2020, who had confirmed or highly suspected COVID-19. Demographic, clinical, laboratory, imaging, and outcome data were analyzed. ICH rates among all strokes were compared to the same time period in 2019 in two-week time intervals. Correlation of systolic blood pressure variability (SBPV) and neutrophil-to-lymphocyte ratio (NLR) to clinical outcomes were performed. RESULTS: Of 324 patients who presented with stroke, 65 (20%) were diagnosed with non-traumatic ICH: 8 had confirmed and 3 had highly suspected COVID-19. Nine (82%) had at least one associated risk factor for ICH. Three ICHs occurred during inpatient anticoagulation. More than half (6) suffered either deep or cerebellar hemorrhages; only 2 were lobar hemorrhages. Two of 8 patients with severe pneumonia survived. During the NYC COVID-19 peak period in April, ICH comprised the highest percentage of all strokes (40%), and then steadily decreased week-after-week (p = 0.02). SBPV and NLR were moderately and weakly positively correlated to discharge modified Rankin Scale, respectively. CONCLUSIONS: COVID-19 associated ICH is often associated with at least one known ICH risk factor and severe pneumonia. There was a suggestive relative surge in ICH among all stroke types during the first peak of the NYC pandemic. It is important to be vigilant of ICH as a possible and important manifestation of COVID-19. Elsevier Inc. 2021-04 2021-01-08 /pmc/articles/PMC7831866/ /pubmed/33484980 http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.105603 Text en © 2021 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Article Mishra, Sanskriti Choueka, Murray Wang, Qiang Hu, Chloe Visone, Stephanie Silver, Michael Stein, Evan G. Levine, Steven R. Wang, Qingliang T. Intracranial Hemorrhage in COVID-19 Patients |
title | Intracranial Hemorrhage in COVID-19 Patients |
title_full | Intracranial Hemorrhage in COVID-19 Patients |
title_fullStr | Intracranial Hemorrhage in COVID-19 Patients |
title_full_unstemmed | Intracranial Hemorrhage in COVID-19 Patients |
title_short | Intracranial Hemorrhage in COVID-19 Patients |
title_sort | intracranial hemorrhage in covid-19 patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7831866/ https://www.ncbi.nlm.nih.gov/pubmed/33484980 http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2021.105603 |
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