Intracranial hemorrhage in coronavirus disease 2019 (COVID-19) patients.
Intracranial hemorrhage in coronavirus disease 2019 (COVID-19) patients.
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DOI：
10.1007/s10072-020-04870-z
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Ogeng'o JA
中科院分区：
文献类型：
--
作者：
Cheruiyot I;Sehmi P;Ominde B;Bundi P;Mislani M;Ngure B;Olabu B;Ogeng'o JA
新出现的证据表明，冠状病毒病2019(新冠肺炎)患者的一部分可能在住院期间出现或发展为脑血管疾病。虽然新冠肺炎患者中的缺血性卒中已经被很好地描述，但关于这些患者中的颅内出血的数据仍然有限。因此，我们对当前的科学文献进行了快速系统的回顾，以确定和巩固新冠肺炎患者中存在脑出血的证据。从2019年11月1日至2020年8月14日在PubMed和中国国家知识基础设施(CNKI)上进行了系统的文献检索，以确定符合条件的研究。共有23项研究描述了148名新冠肺炎患者的脑出血。新冠肺炎患者脑出血的混合发生率为0.7%(95%可信区间为0.5~0.9)，研究间异质性较低(I2=33.6%，Cochran‘s q=12.05，p=0.149)。大多数患者是老年男性患者(65.8%)合并疾病，最常见的是全身性高血压(54%)。9.5%的病例报告了累及多个颅腔的出血。其余均为单室，脑实质内出血(IPH)最常见(62.6%)，脑室内出血(IVH)最少见(1.4%)。这些患者中有一半接受了某种形式的抗凝治疗。总体而言，新冠肺炎脑出血患者的死亡率约为48.6%。虽然在新冠肺炎患者中相对较少见，但脑出血与高死亡率有关。早期识别有发生脑出血风险的患者，特别是合并疾病和接受抗凝治疗的患者，对于改善预后可能是重要的。
Emerging evidence suggests that a subset of coronavirus disease 2019 (COVID-19) patients may present with or develop cerebrovascular disease during the course of hospitalization. Whereas ischemic stroke in COVID-19 patients has been well described, data on intracranial hemorrhage (ICH) in these patients is still limited. We, therefore, conducted a rapid systematic review of current scientific literature to identify and consolidate evidence of ICH in COVID-19 patients. A systematic search of literature was conducted between November 1, 2019, and August 14, 2020, on PubMed and China National Knowledge Infrastructure (CNKI) to identify eligible studies. A total of 23 studies describing ICH in 148 COVID-19 patients were included. The pooled incidence of ICH in COVID-19 patients was 0.7% (95% CI 0.5–0.9), with low levels of inter-study heterogeneity observed (I2 = 33.6%, Cochran’s Q = 12.05, p = 0.149). Most of the patients were elderly male patients (65.8%) with comorbidities, the most common being systemic hypertension (54%). Hemorrhage involving multiple cranial compartments was reported in 9.5% of cases. Single compartments were involved in the rest, with intraparenchymal hemorrhage (IPH) being the most common variety (62.6%) and intraventricular hemorrhage (IVH) the least common (1.4%). Half of these patients were on some form of anticoagulation. Overall, the mortality rate in the COVID-19 patients with ICH was about 48.6%. Although relatively uncommon among COVID-19 patients, ICH is associated with a high mortality rate. Early identification of patients at risk of developing ICH, particularly with comorbid conditions and on anticoagulant therapy, may be important to improve outcomes.
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