Martio Artur Eduardo, Soares Pedro de Moraes Rêgo, Karam Octávio Ruschel, Padua Wagner Lazaretto, Manzato Luciano Bambini, Mesquita Filho Paulo Moacir
Neurosurgery Department, Hospital de Clínicas de Passo Fundo, Passo Fundo, Brazil.
Brain Hemorrhages. 2023 Jun;4(2):57-64. doi: 10.1016/j.hest.2023.01.002. Epub 2023 Jan 19.
The present study seeks to overcome the lack of data on Covid-19 associated intracranial hemorrhage (ICH) in Brazil.
This is a retrospective, single-center case series of consecutive patients. It is a subanalysis of a larger study still in progress, which covers all neurological manifestations that occurred in patients admitted between March 1st, 2020 and June 1st, 2022, with active SARS-CoV-2 infection confirmed by polymerase chain reaction test. All patients with non-traumatic ICH were included.
A total of 1675 patients were evaluated: 917 (54.75 %) had one or more neurological symptoms and 19 had non-traumatic ICH, comprising an incidence of 1.13 %. All patients had one or more risk factors for ICH. The presence of neurological manifestations before the ICH and ICU admission showed a statistically significant relationship with the occurrence of ICH (X = 6.734, = 0.0095; OR = 4.47; CI = 1.3-15.4; and FET = 9.13; = <0.001; OR = 9.15; CI = 3.27-25.5 respectively).
Our findings were largely congruent with the world literature. We believe that the assessment of risk factors can accurately predict the subgroup of patients at increased risk of ICH, but further studies are needed to confirm these hypotheses.
本研究旨在克服巴西缺乏新型冠状病毒肺炎(Covid-19)相关颅内出血(ICH)数据的问题。
这是一项回顾性、单中心的连续患者病例系列研究。它是一项仍在进行的更大规模研究的子分析,该研究涵盖了2020年3月1日至2022年6月1日期间入院的、经聚合酶链反应检测确诊为活动性严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染患者出现的所有神经学表现。纳入所有非创伤性ICH患者。
共评估了1675例患者:917例(54.75%)有1种或多种神经学症状,19例有非创伤性ICH,发病率为1.13%。所有患者均有1种或多种ICH危险因素。ICH和入住重症监护病房(ICU)前出现神经学表现与ICH的发生存在统计学显著关系(X = 6.734,P = 0.0095;比值比[OR] = 4.47;可信区间[CI] = 1.3 - 15.4;费希尔精确检验[FET] = 9.13;P = <0.001;OR = 9.15;CI = 3.27 - 25.5)。
我们的研究结果与世界文献基本一致。我们认为,对危险因素的评估可以准确预测ICH风险增加的患者亚组,但需要进一步研究来证实这些假设。