COVID-19 Impact on Intraparenchymal Hemorrhage and Surgical Outcomes: A Comprehensive Analysis

To investigate the possible association between COVID-19 infection and intraparenchymal hemorrhage (IPH) by examining changes in the preoperative and postoperative periods, mortality, and the impact of COVID-19 on IPH survival times.

This cross-sectional retrospective analysis included 82 IPH cases operated on and treated between January 2021 and March 2023. Brain computed tomography/magnetic resonance imaging scans were used to confirm the diagnosis of IPH and provide evidence of neurological damage. The information was gathered using a predesigned form of hospital records. Participants were included if they had a positive COVID-19 result or displayed no symptoms, indicating a past infection.

The study included 82 people, nine (11%) of who tested positive for COVID-19 and 73 (89%) tested negative. There was no difference in mortality rates between the two groups (p=0.651). The hematoma volume decreased from the preoperative (82.4 ± 42.4) to the postoperative (23.7 ± 44.8) measurement (p < 0.001). The midline shift value decreased from the preoperative (9.26 ± 4.71) to the postoperative (5.16 ± 5.06) assessment (p < 0.001). Patients without COVID-19 infection had a mean survival time of 31.5 days and a median survival time of 23 days, whereas patients with COVID-19 infection had a survival time of 25.7 days and a median survival time of 8 days.

Our findings show that hematoma volume and midline shift improve significantly after surgery, although GCS scores remain unaltered. Except for AST and ALT levels, there were no significant differences in mortality rates, demographic, clinical, and most laboratory results between COVID-19-positive and COVID-19-negative patients.