Intracranial hemorrhage in critically ill patients hospitalized for COVID-19
Intracranial hemorrhage in critically ill patients hospitalized for COVID-19
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DOI：
10.1016/j.jocn.2020.08.026
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发表时间：
2020-11-01
影响因子：
2
通讯作者：
Mai, Jeffrey C.
中科院分区：
文献类型：
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作者：
Fayed, Islam;Pivazyan, Gnel;Mai, Jeffrey C.
在这项研究中，我们报告了三例自发性颅内出血患者，这些患者最初在华盛顿特区的三级医疗中心住院，症状为COVID-19。三名患者均被诊断为严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染，病情危重，需要插管和呼吸支持。在他们长期住院期间，随后的影像学显示颅内出血，包括脑内和蛛网膜下腔出血，在抗凝和凝血障碍的背景下。我们认为这与SARS-CoV-2通过其血管紧张素转换酶（ACE） II受体向脑血管内皮层的趋向性有关。鉴于我们的研究结果，我们提倡提高对脑出血事件的警惕，并在可行的情况下对延长呼吸支持时间和神经系统检查结果较低的COVID-19患者进行扫描。(C) 2020由Elsevier Ltd.出版。
In this study, we report three cases of spontaneous intracranial hemorrhage in patients who were initially hospitalized at our tertiary care center in Washington, DC with symptoms of COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed in all three patients, who were critically ill, requiring intubation and ventilatory support. During their protracted hospitalizations, subsequent imaging disclosed intracranial hemorrhages, including intracerebral and subarachnoid hemorrhages, in the context of anticoagulation and coagulopathy. We believe this is related to the tropism of SARS-CoV-2 to the endothelial lining of the cerebral vasculature via their angiotensin-converting enzyme (ACE) II receptors. Given our findings, we advocate heightened vigilance for intracerebral hemorrhage events, and scanning when practicable, in COVID-19 patients which have prolonged ventilatory support and depressed neurologic examinations. (C) 2020 Published by Elsevier Ltd.