Article
Risk and extent of intracranial haemorrhage in patients with COVID-19 infection admitted to intensive care unit
Risiko und Ausmaß intracranialer Blutungen bei Patienten mit einer COVID-19-Infektion auf der Intensivstation
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Authors
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George Simion
- Universitätsklinikum Jena, Klinik und Poliklinik für Neurochirurgie, Jena, Deutschland
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Marcel A. Kamp
- Universitätsklinikum Jena, Klinik und Poliklinik für Neurochirurgie, Jena, Deutschland
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Christian A. Senft
- Universitätsklinikum Jena, Klinik und Poliklinik für Neurochirurgie, Jena, Deutschland
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Nazife Dinc
- Universitätsklinikum Jena, Klinik und Poliklinik für Neurochirurgie, Jena, Deutschland
| Published: | May 25, 2022 |
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Outline
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Objective: The SARS-Cov2 pandemic has not yet been overcome even after 2 years. On the contrary, the number of corona patients is increasing and subsequently the number of patients with severe infection and neurosurgical-relevant complications. Intracranial bleeding is a dreaded concomitant complication. Yet, outcome and predictors for poor outcome following SARS-Cov2-associated intracranial haemorrhage (ICH) are not well described. Aim of the present pilot series was to assess outcome of SARS-Cov2-associated ICH and to identify predictors of outcome.
Methods: Inclusion criteria were (1) SARS-Cov2 infection requiring intensive care unit treatment (2) spontaneous SARS-Cov2-associated ICH occurring (3) between 12/2020 and 12/2021 in our tertiary care centre. We dichotomised patients (pts.) into survivors of SARS-Cov2 infection and patients with a fatal outcome. Data were collected from the clinical information systems and analysed using the Prism 9 software (GraphPad).
Results: Within a one year period, 20 pts. with spontaneous SARS-Cov2-associated ICH were treated in our department. 8 pts. suffered from intracerebral haemorrhage, 1 from spontaneous subdural haematoma and 11 pts. from subarachnoid haemorrhage (SAH). Mean age was 61±2.7 years, 6 pts. were female. Mean stay on ICU was 20±3.5 days. 18 pts. required mechanical ventilation with a mean duration of 14±3.2 days. Extracorporal membrane oxygenation was necessary in 8 pts. 13 pts. (65%) died within our hospital treatment. All surviving pts. had a modified Rankin Scale score of 3 or greater at discharge. The only significant predictor for mortality was kidney failure requiring dialysis. There was a statistical trend towards a favourable outcome for female sex, diabetes mellitus, no-assisted ventilation, type of haemorrhage (SAH). Liver cirrhosis, extracorporal membrane oxygenation, hypertension and heart failure had no influence on early outcome.
Conclusion: SARS-Cov2-associated ICH has a high complication rate, but in itself does not result in increased mortality. Kidney failure, however, was asscociated with mortality. We encourage a multicentric collection and analysis of data on SARS-Cov2-associated neurosurgical complications.
