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Published in: Neurological Sciences 1/2021

01-01-2021 | Subdural Hematoma | COVID-19

Intracranial hemorrhage in coronavirus disease 2019 (COVID-19) patients

Authors: Isaac Cheruiyot, Prabjot Sehmi, Beryl Ominde, Paul Bundi, Musa Mislani, Brian Ngure, Beda Olabu, Julius A. Ogeng’o

Published in: Neurological Sciences | Issue 1/2021

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Abstract

Background

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.

Methods

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.

Results

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%.

Conclusion

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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Metadata
Title
Intracranial hemorrhage in coronavirus disease 2019 (COVID-19) patients
Authors
Isaac Cheruiyot
Prabjot Sehmi
Beryl Ominde
Paul Bundi
Musa Mislani
Brian Ngure
Beda Olabu
Julius A. Ogeng’o
Publication date
01-01-2021
Publisher
Springer International Publishing
Published in
Neurological Sciences / Issue 1/2021
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI
https://doi.org/10.1007/s10072-020-04870-z

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