COVID-19 Infection Is Associated With Poor Outcomes in Patients With Intracerebral Hemorrhage

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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation

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Daniela Renedo1,2, Audrey C Leasure1, Rebecca Young3

  • 1Department of Neurology Yale School of Medicine New Haven CT.

Journal of the American Heart Association
|January 31, 2024
PubMed

Insights

COVID-19 infection significantly worsens outcomes for patients with intracerebral hemorrhage (ICH). This includes higher risks of poor functional outcomes, mortality, and need for skilled nursing care, highlighting the pandemic's impact on stroke patient health.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • COVID-19 infection is linked to poorer outcomes in ischemic stroke patients.
  • The effect of COVID-19 on outcomes for patients with intracerebral hemorrhage (ICH) was previously unclear.
  • This study investigated the impact of COVID-19 on ICH patient outcomes.

Purpose of the Study:

  • To assess if COVID-19 infection exacerbates outcomes in patients diagnosed with intracerebral hemorrhage (ICH).
  • To compare the functional outcomes, mortality rates, and discharge dispositions of ICH patients with and without COVID-19.
  • To evaluate the impact of the COVID-19 pandemic on ICH patient outcomes compared to prepandemic periods.

Main Methods:

  • An observational study utilizing the Get With The Guidelines Stroke database.
  • Comparison of ICH patients who were COVID-19 positive versus negative during the pandemic (March 2020-February 2021).
  • Analysis of outcomes including poor functional outcome (modified Rankin Scale 4-6), mortality, and discharge to skilled nursing facility/hospice, comparing pandemic vs. prepandemic periods (March 2019-February 2020).

Main Results:

  • ICH patients with COVID-19 had significantly higher odds of poor functional outcome (OR 1.68), mortality (OR 1.51), and discharge to skilled nursing/hospice (OR 1.66) compared to COVID-19 negative patients.
  • ICH patients admitted during the pandemic showed higher odds of poor outcomes (OR 1.10) and mortality (OR 1.05) compared to those admitted before the pandemic.
  • No significant difference was observed in the risk of discharge to skilled nursing facility/hospice for ICH patients admitted during versus before the pandemic (OR 0.93).

Conclusions:

  • COVID-19 infection is associated with substantially worse outcomes for patients experiencing intracerebral hemorrhage.
  • Changes in healthcare delivery during the COVID-19 pandemic may have also contributed to poorer outcomes in ICH patients.
  • The combined effects of viral pathophysiology and healthcare system changes negatively impacted ICH patient recovery and survival.
Abstract

Keywords:
COVID‐19Get With The Guidelines Strokeintracerebral hemorrhagemodified Rankin scale

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