Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage
Clinical and Imaging Characteristics in Patients with SARS-CoV-2 Infection and Acute Intracranial Hemorrhage
复制标题
DOI：
10.3390/jcm9082543
复制
发表时间：
2020-08-01
影响因子：
3.9
通讯作者：
Sporns, Peter
中科院分区：
文献类型：
--
作者：
Nawabi, Jawed;Morotti, Andrea;Sporns, Peter
背景和目的：在严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染 (COVID-19) 患者中观察到颅内出血，但 COVID-19 感染期间颅内出血的临床、影像学和病理生理学特征仍不清楚。本研究描述了欧洲多中心队列中出现颅内出血的 COVID-19 感染患者的临床和影像学特征。方法：这是一个多中心回顾性、观察性病例系列，包括 18 名连续的 COVID-19 感染和颅内出血患者。数据是从 2020 年 2 月至 5 月在五个指定的欧洲 COVID-19 特殊护理中心收集的。 COVID-19 的诊断是基于 SARS-CoV-2 的实验室确诊诊断。在 COVID-19 诊断之日起 1 个月内，通过大脑计算机断层扫描 (CT) 诊断出颅内出血。对出现颅内出血的 COVID-19 患者的临床、实验室、放射学和病理学结果、治疗和结果进行了分析。结果：18 名患者在入院 11 天内（IQR 9-29）有急性颅内出血的证据。 6 例患者出现脑实质出血（33.3%），11 例患者出现蛛网膜下腔出血（SAH）（61.1%），1 例患者出现硬膜下出血（5.6%）。 3 名患者出现脑室内出血 (IVH) (16.7%)。结论：这项研究代表了基于 SARS-CoV-2 地理空间热点的主要欧洲国家诊断为 COVID-19 的颅内出血患者的最大病例系列。沿着凸面的孤立性 SAH 可能是主要的出血表现，并且可能发生在严重的 COVID-19 的晚期时间过程中。
Background and Purpose: Intracranial hemorrhage has been observed in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19), but the clinical, imaging, and pathophysiological features of intracranial bleeding during COVID-19 infection remain poorly characterized. This study describes clinical and imaging characteristics of patients with COVID-19 infection who presented with intracranial bleeding in a European multicenter cohort. Methods: This is a multicenter retrospective, observational case series including 18 consecutive patients with COVID-19 infection and intracranial hemorrhage. Data were collected from February to May 2020 at five designated European special care centers for COVID-19. The diagnosis of COVID-19 was based on laboratory-confirmed diagnosis of SARS-CoV-2. Intracranial bleeding was diagnosed on computed tomography (CT) of the brain within one month of the date of COVID-19 diagnosis. The clinical, laboratory, radiologic, and pathologic findings, therapy and outcomes in COVID-19 patients presenting with intracranial bleeding were analyzed. Results: Eighteen patients had evidence of acute intracranial bleeding within 11 days (IQR 9-29) of admission. Six patients had parenchymal hemorrhage (33.3%), 11 had subarachnoid hemorrhage (SAH) (61.1%), and one patient had subdural hemorrhage (5.6%). Three patients presented with intraventricular hemorrhage (IVH) (16.7%). Conclusion: This study represents the largest case series of patients with intracranial hemorrhage diagnosed with COVID-19 based on key European countries with geospatial hotspots of SARS-CoV-2. Isolated SAH along the convexity may be a predominant bleeding manifestation and may occur in a late temporal course of severe COVID-19.