The clinical, laboratory and prognostic characteristics of haemorrhagic stroke cases related to COVID-19 infection haemorrhagic stroke and COVID-19 infection
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Abstract
Objective: Although ischemic and thrombotic vascular processes are more widely reported in COVID-19, the ratio of haemorrhagic cerebrovascular disease is lower. However, it needs to be evaluated because the mortality rate is higher in haemorrhages, and they may appear iatrogenically.
Material and Methods: Patients observed at the Prof. Dr. Cemil Taşçıoğlu City Hospital between March 11th, 2020, and March 11th, 2021, were included in the study. Cases diagnosed as consecutive full intracerebral haemorrhage and concomitant with COVID-19 were observed during the study period. This study is a cross-sectional, retrospective, and observational study.
Results: Within the 1-year period, 11 patients (7 men and 4 women) with a mean age of 64.45±18.68 years related to COVID-19 were recorded. Risk factors were high blood pressure at a frequency of 64%, diabetes mellitus at 45%, and the use of antiaggregants/anticoagulants at 36%. The ratio of male patients was 64% (n=7). The location of haemorrhage was intraparenchymal in 91% (n=10), and subdural in 9% (n=1). The mortality rate was 64%.
Conclusion: Neurologic findings that develop, especially in noncooperating and prone patients in wards and intensive care units, must be observed carefully. Caution must be exercised in prophylactic antiaggregant and anticoagulant treatment, especially in high-risk patients. Intracranial haemorrhages are important due to high mortality.
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Accepted 2021-11-20
Published 2021-11-23
References
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054-1062.
Wang T, Chen R, Liu C, et al. Attention should be paid to venous thromboembolism prophylaxis in the management of COVID-19. Lancet Haematol 2020;7:e362-e363
Cheruiyot I, Sehmi P, Ominde B, Bundi P, Mislani M, Ngure B, Olabu B, Ogeng’o JA. Intracranial hemorrhage in coronavirus disease 2019 (COVID-19) patients. Neurol Sci 2021; 42:25–33
Connors JM, Levy JH. COVID-19 and its implications for thrombosis and anticoagulation. Blood 2020;135 (23): 2033–2040.
Pavlov V, Beylerli O, Gareev I, Torres Solis LF, Solís Herrera A and Aliev G. COVID-19-related intracerebral hemorrhage. Front. Aging Neurosci.2020; 12:600172. doi: 10.3389/fnagi.2020.600172
Rothstein A, Oldridge O, Schwennesen H, Do D, Cucchiara BL, Acute Cerebrovascular Events in Hospitalized COVID-19 Patients. Stroke. 2020;51:e219–e222.
Altschula DJ, Undaa SR, Garza Ramosa RL, Zampolinb R, Bentona J, Hollanda R, Fortunela A, Haranhallia N. Hemorrhagic presentations of COVID-19: Risk factors for mortality Clinical Neurology and Neurosurgery 2020;198 106112
Radmanesh A, Derman A, Lui YW, Raz E, Loh JP, Hagiwara M, Borja MJ, Zan E, Fatterpekar GM, COVID-19–associated Diffuse Leukoencephalopathy and Microhemorrhages. Radiology 2020; 297:E223–E227
Dogra S, Jain R, Cao M, Bilaloglu S, Zagzag D, Hochman S, Lewis A, Melmed K, Hochman K, Horwitz L, Galetta S, Berger J, Hemorrhagic stroke and anticoagulation in COVID-19Journal of Stroke and Cerebrovascular Diseases,2020; 29(8 ) 104984
Bhanu Gogia, Xiang Fang, Prashant Rai Intracranial Hemorrhage in a Patient With COVID-19: Possible Explanations and Considerations cureus 2020; 12(8): e10159. DOI 10.7759/cureus.10159
Ghani MU, Kumar M, Ghani U, Sonia F, Abbas SA. Intracranial hemorrhage complicating anticoagulant prophylactic therapy in three hospitalized COVID-19 patients Journal of NeuroVirology 2020; 26:602–604
Montemurroa N. Intracranial hemorrhage and COVID-19, but please do not forget “old diseases” and elective surgery Brain, Behavior, and Immunity 2021;92 207–208
Aghagoli G, Gallo Marin B, Katchur NJ, Chaves-Sell F, Asaad WF, Murphy SA. Neurological involvement in COVID-19 and potential mechanisms: a review. Neurocrit Care 2020.
Fady Mousa-Ibrahim FM, Berg S, Od`TPDetola O, Teitcher M, Ruland S, Intracranial Hemorrhage in Hospitalized SARS-CoV-2 Patients: A Case Series Journal of Stroke and Cerebrovascular Diseases 2021:30 (1) 105428
Wang F, Wang L, Jiang TT, Xia JJ, Xu F, Shen LJ, et al. Neutrophil to-lymphocyte ratio is an independent predictor of 30-day mortality of intracerebral hemorrhage patients: a validation cohort study. Neurotox Res 2018.
Ciccullo A, Borghetti A, Zileri Dal Verme L, et al. Neutrophil- to-lymphocyte ratio and clinical outcome in COVID- 19: a report from the Italian front line. Int J Antimicrob Agents 2020;56(2):106017.
Moriguchi T, Harii N, Goto J, et al. A first case of meningitis/ encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis 2020;94:55-58.
Varga Z, Flammer AJ, Steiger P, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet 2020;395 (10234):1417-1418.
Al-Samkari H, Karp Leaf RS, Dzik WH, et al. COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection. Blood 2020;136(4):489-500. Al-Samkari H, Karp Leaf RS, Dzik WH, et al. COVID-19 and coagulation: bleeding and thrombotic manifestations of SARS-CoV-2 infection. Blood 2020;136(4):489-500.
Wang, L. C-reactive protein levels in the early stage of COVID- 19. Med. Mal. Infect.2020 50, 332–334.
Nawabi J, Morotti A, Wildgruber M, Boulouis G, Kraehling H, Schlunk F et al. Clinical and imaging characteristics in patients with SARS-CoV-2 infection and acute intracranial hemorrhage. J Clin Med 2020 9(8):2543