Department of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
Department of neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
BMC Neurol. 2021 Feb 19;21(1):83. doi: 10.1186/s12883-021-02109-8.
The respiratory system involvement is the most common presentation of Coronavirus disease 2019 (COVID-19). However, other organs including the central nervous system (CNS) could be affected by the virus. Strokes, seizures, change in mental status, and encephalitis have been reported as the neurological manifestation of the disease. We hypothesized that COVID-19 could predispose younger patients to spontaneous intracerebral hemorrhage (ICH). The present study aimed to investigate whether COVID-19 has any relationship with the occurrence of spontaneous ICH in young or not.
We retrospectively evaluated all the patients with spontaneous ICH who were referred to our center between 20 Feb and 1 Sep 2020. The demographic, clinical, radiological, and laboratory test data were evaluated. Patients were divided into two groups. The COVID-19 positive patients and COVID-19 negative ones. All the variables including age, sex, history of hypertension, diabetes mellitus, smoking, Glasgow Coma Scale (GCS), hematoma volume and location, the presence of intraventricular hemorrhage and hydrocephalus on admission, the length of hospital stay, the lab test results and the clinical outcome at last visit or discharge as Glasgow Outcome Scale (GOS) were compared between the two groups.
There were 22 COVID-19 positive patients (20.8%) and 84 COVID-19 negative ones (79.2%). The mean age of the patients in the case group (54.27 ± 4.67) was significantly lower than that in the control group (69.88 ± 4.47) (p < 0.05). Meanwhile, our results showed a significant difference between the two groups based on the presence of chronic arterial hypertension (p < 0.05). There were no significant differences between the two groups based on gender, diabetes mellitus, smoking, Glasgow Coma Scale (GCS), hematoma volume, need for surgery, the presence of intraventricular hemorrhage and hydrocephalus on admission, White Blood Cell (WBC) count, platelet count, Prothrombin Time (PT), and Partial Thromboplastin Time (PTT) (p > 0.05).
Our results show that COVID positive patients with ICH are younger and with less predisposing factors than COVID negative subjects with ICH.
呼吸系统受累是 2019 年冠状病毒病（COVID-19）最常见的表现。然而，其他器官，包括中枢神经系统（CNS），也可能受到病毒的影响。中风、癫痫发作、精神状态改变和脑炎已被报道为该疾病的神经表现。我们假设 COVID-19 可能使年轻患者更容易发生自发性脑出血（ICH）。本研究旨在探讨 COVID-19 是否与年轻患者自发性 ICH 的发生有关。
我们回顾性评估了 2020 年 2 月 20 日至 9 月 1 日期间我院收治的所有自发性 ICH 患者。评估了患者的人口统计学、临床、影像学和实验室检查数据。患者分为两组：COVID-19 阳性组和 COVID-19 阴性组。比较了两组之间的所有变量，包括年龄、性别、高血压病史、糖尿病史、吸烟史、格拉斯哥昏迷量表（GCS）、血肿体积和位置、入院时是否存在脑室内出血和脑积水、住院时间、实验室检查结果以及最后一次就诊或出院时的临床结局格拉斯哥预后量表（GOS）。
COVID-19 阳性患者 22 例（20.8%），COVID-19 阴性患者 84 例（79.2%）。病例组患者的平均年龄（54.27±4.67）明显低于对照组（69.88±4.47）（p<0.05）。同时，我们的研究结果表明，两组间存在慢性动脉高血压的差异有统计学意义（p<0.05）。两组间性别、糖尿病、吸烟、格拉斯哥昏迷量表（GCS）、血肿体积、是否需要手术、入院时脑室内出血和脑积水的存在、白细胞计数（WBC）、血小板计数、凝血酶原时间（PT）和部分凝血活酶时间（PTT）的差异无统计学意义（p>0.05）。
我们的结果表明，COVID-19 阳性的 ICH 患者比 COVID-19 阴性的 ICH 患者年轻，且易患因素较少。
