Spontaneous Intracerebral Hemorrhages in the Post-COVID-19 Period without Classical Risk Factors: Clinical...

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• Intracranial hemorrhages (ICH) are a serious neurological complication.
• The association between COVID-19 and ICH in patients lacking traditional risk factors is increasingly recognized.
• Understanding these post-COVID-19 ICH cases is crucial for clinical management.

Purpose of the Study:

• To evaluate the clinical characteristics of spontaneous intracranial hemorrhages in the post-COVID-19 period.
• To analyze these hemorrhages in patients without common risk factors like hypertension or anticoagulant use.
• To compare findings with existing literature on spontaneous ICH.

Main Methods:

• Retrospective review of 36 patients with prior COVID-19 and spontaneous intracerebral hemorrhage (2020-2024).
• Evaluation of demographic data, Glasgow Coma Scale (GCS), INR, hemorrhage type/location, modified Rankin Scale (mRS), and outcomes.
• Exclusion of patients with macroscopic vascular pathology.

Main Results:

• Mean patient age was 52.0 years, with 61.1% males; overall mortality was 47.2%.
• Parenchymal hemorrhages (55.6%) were most common; subarachnoid hemorrhages had the highest mortality (87.5%).
• GCS score significantly correlated with mortality (p=0.0001), while INR and age did not.

Conclusions:

• Intracerebral hemorrhages in post-COVID-19 patients without classical risk factors are a distinct clinical entity.
• High mortality and functional dependency rates underscore the need for novel management strategies.
• Early diagnosis and long-term monitoring are essential for this patient group.