The relationship between COVID-19 infection and intracranial hemorrhage: A systematic review.

The relationship between COVID-19 infection and intracranial hemorrhage: A systematic review.
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DOI:
10.1016/j.hest.2021.11.003
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发表时间:
2021-12
期刊:
影响因子:
--
通讯作者:
Huang JH
Huang JH
中科院分区:
其他
文献类型:
--
作者:
Daly SR;Nguyen AV;Zhang Y;Feng D;Huang JH

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新冠肺炎除了对肺部和心血管系统有害外,还会对神经系统造成损害。本综述旨在探讨新冠肺炎与颅内出血之间关系的文献。我们对发表在新冠肺炎和脑出血上的文献进行了系统的综述。295篇筛选出的论文中有94篇符合纳入标准。这些文献描述了新冠肺炎相关脑出血的发生率和死亡率。新冠肺炎合并蛛网膜下腔出血、脑实质内出血、硬膜下血肿、脑静脉血栓形成、缺血性卒中继发出血等。新冠肺炎感染期间的ICH与发病率和死亡率的增加有关。脑出血的危险因素似乎是治疗性抗凝、体外反搏和机械通气。根据新冠肺炎感染的严重程度和神经损伤,结果差异很大。虽然严重新冠肺炎感染的治疗通常针对急性呼吸窘迫综合征、血管病变和凝血障碍,但也可能发生神经损伤。提高新冠肺炎死亡率的循证治疗也可能增加发生脑出血的风险。提供者应该意识到新冠肺炎潜在的神经后遗症,排除脑出血其他原因的诊断方法,以及治疗方案。
In addition to the deleterious effects Covid-19 has on the pulmonary and cardiovascular systems, COVID-19 can also result in damage to the nervous system. This review aims to explore current literature on the association between COVID-19 and intracranial hemorrhage (ICH). We conducted a systematic review of PubMed for literature published on COVID-19 and ICH. Ninety-four of 295 screened papers met inclusion criteria. The literature addressed incidence and mortality of ICH associated with Covid-19. It also revealed cases of COVID-19 patients with subarachnoid hemorrhage, intraparenchymal hemorrhage, subdural hematomas, and hemorrhage secondary to cerebral venous thrombosis and ischemic stroke. ICH during COVID-19 infections was associated with increased morbidity and mortality. Risk factors for ICH appeared to be therapeutic anticoagulation, ECMO, and mechanical ventilation. Outcomes varied widely, depending on the severity of COVID-19 infection and neurologic injury. Although treatment for severe Covid-19 infections is often aimed at addressing acute respiratory distress syndrome, vasculopathy, and coagulopathy, neurologic injury can also occur. Evidence-based treatments that improve COVID-19 mortality may also increase risk for developing ICH. Providers should be aware of potential neurologic sequelae of COVID-19, diagnostic methods to rule out other causes of ICH, and treatment regimens.
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