Subarachnoid hemorrhage and COVID-19: Association or coincidence?

Abstract:

ABSTRACT:Some evidences suggest the involvement of the central nervous system in patients infected with SARS-CoV-2. We aim to analyze possible associations between coronavirus disease 2019 (COVID-19) pandemic and spontaneous subarachnoid hemorrhage (SAH), in a comprehensive neurological center.We conducted a retrospective case series of 4 patients infected by COVID-19, who developed spontaneous SAH. Clinical data were extracted from electronic medical records.Between March 24, 2020, and May 22, 2020, 4 cases (3 females; 1 male) of SAH were identified in patients infected with SARS-CoV-2, in a comprehensive neurological center in Brazil. The median age was 55.25 years (range 36 -71). COVID-19-related pneumonia was severe in 3 out of 4 cases, and all patients required critical care support during hospitalization. The patients developed Fisher grade III and IV SAH. Digital subtraction angiography (DSA) was performed in 3 of the 4 patients. However, in only 1 case, an aneurysm was identified. Inflammatory blood tests were elevated in all cases, with an average D-dimer of 2336 μg/L and mean C-reactive protein (CRP) of 3835 mg/dl The outcome was poor in the majority of the patients, with 1 death (25%); 2 (50%) remained severely neurologically affected (mRS:4); and 1 (25%) had slight disability (mRS:2).This study shows a series of 4 rare cases of SHA associated with COVID-19. The possible mechanisms underlying the involvement of SARSCoV-2 and SHA is yet to be fully understood. Therefore, SHA should be included in severe neurological manifestations in patients infected by this virus.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Cezar-Junior AB,Faquini IV,Silva JLJ,de Carvalho Junior EV,Lemos LEAS,Freire Filho JBM,de Lira Filho HT,Pontes ECA,Almeida NS,Azevedo-Filho HRC

doi

10.1097/MD.0000000000023862

subject

Has Abstract

pub_date

2020-12-18 00:00:00

pages

e23862

issue

51

eissn

0025-7974

issn

1536-5964

pii

00005792-202012180-00118

journal_volume

99

pub_type

杂志文章

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