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Published on: October 15, 2021
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COVID-19 and Intracranial Hemorrhage: A Multicenter Case Series, Systematic Review and Pooled Analysis
Moritz L Schmidbauer1, Caroline Ferse2, Farid Salih3
1Department of Neurology, University Hospital LMU Munich, 81377 Munich, Germany.
Journal of Clinical Medicine
|February 15, 2022
Summary
Intracranial hemorrhage (ICH) in COVID-19 patients is rare but deadly, with a high mortality rate. Understanding its varied causes is crucial for managing these complex cases.
Area of Science:
- Neurology
- Infectious Diseases
- Hematology
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) significantly affects blood clotting and small blood vessels.
- Managing the balance between blood clots and bleeding is a major challenge in COVID-19 patients.
Purpose of the Study:
- To systematically investigate the occurrence, death rates, imaging types, and clinical features of intracranial hemorrhage (ICH) in patients with coronavirus disease (COVID-19).
Main Methods:
- A systematic literature review following PRISMA guidelines was conducted using PubMed.
- Included were patients diagnosed with COVID-19 and concurrent ICH.
- A pooled analysis of critically ill COVID-19 patients with ICH was performed as part of the PANDEMIC registry.
Main Results:
- The review included 79 studies with 477 patients; median age was 58.8 years.
- Prevalence of ICH was 0.85%, with a mortality rate of 52.18%.
- 23.3% of patients were critically ill, 62.7% were on anticoagulation, and 27.5% received ECMO.
Conclusions:
- Intracranial hemorrhage in COVID-19 patients is uncommon but associated with a very poor prognosis.
- The diverse subtypes of ICH suggest complex and varied underlying mechanisms in COVID-19.
- Further research is needed to clarify the interplay between clotting and bleeding complications.
