COVID-19患者急性中风:哥伦比亚一家医院的第一年经验
N Cerón Blanco1, C A Romero Hernández2, J Vallejo Fernández3
1Residente de Neurología, Universidad del Rosario, Fundación, Cardioinfantil, Colombia.
Neurology perspectives
|June 12, 2023
概括
COVID-19是中风的危险因素,超过4%的中风患者检测出SARS-CoV-2阳性. 这些患者经常经历严重的COVID-19和不良的中风结果,突出显示高凝血是潜在的原因.
科学领域:
- 神经学 神经学
- 传染性疾病 传染性疾病
- 心血管研究研究心血管研究
背景情况:
- COVID-19 (冠状病毒疾病2019) 越来越被认为是脑血管事件的潜在危险因素,包括中风.
- 在COVID-19患者中,中风的发病率在1.1%至8.1%之间,与与SARS-CoV-2 (严重急性呼吸系统综合征冠状病毒2) 感染相关的各种病理生理机制有关.
研究的目的:
- 描述在一个哥伦比亚医疗中心同时诊断患有急性中风和COVID-19感染的患者.
- 在SARS-CoV-2感染的背景下分析中风的人口,临床和病因特征.
主要方法:
- 在2020年3月至2021年3月期间,对急性中风和SARS-CoV-2的阳性PCR (聚合酶链反应) 测试的患者进行了医疗记录的回顾性审查.
- 收集的数据包括患者人口统计,中风特征,COVID-19严重程度,炎症生物标志物,接受的治疗和临床结果.
- 用描述性统计来总结这些发现,将连续变量呈现为平均值和范围,并将分类变量呈现为频率和百分比.
主要成果:
- 在328名急性中风患者中,14人 (4.2%) 检测出SARS-CoV-2阳性. 平均年龄为56.4岁,其中57%为男性.
- 11名患者 (78.5%) 被诊断为缺血性中风,主要影响前部循环. 所有患者都存在炎症标志物 (D-二聚体,费里丁,LDH) 的升高.
- 显著的比例 (85.7%) 患有严重的COVID-19,其中64.3%经历了不利的结果 (修改的兰金尺度> 2),住院病例死亡率为14.2%.
结论:
- 感染COVID-19可能会使易患中风的个体易患中风,可能由高凝血和免疫相关的血栓形成.
- 哥伦比亚COVID-19相关中风患者的临床概况和结果与国际观察一致.
- 在COVID-19患者中,迅速识别和管理中风至关重要,考虑到严重疾病和不良神经结果的高发病率.
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