Lintas Konstantinos, Rohde Stefan, Ellrichmann Gisa, El-Hamalawi Boris, Sarge Robert, Müller Oliver
Neurosurgical Department, Dortmund Hospital, Germany.
Radiological and Neuroradiological Department, Dortmund Hospital, Germany.
Brain Spine. 2023;3:101757. doi: 10.1016/j.bas.2023.101757. Epub 2023 May 11.
During the COVID-19-pandemic a significant decrease of up to 13% of all kinds of medical emergencies was reported. Similar trends were expected for aneurysmal subarachnoid hemorrhages (aSAH) and/or symptomatic aneurysms.
To analyze a correlation of the SARS-CoV2-infection and the incidence of aSAH, and to assess the impact of the pandemic-lockdown on the incidence, the outcome and the course of patients suffering from aSAH and/or aneurysms.
From March 16th, 2020 (first lockdown in Germany) to January 31st, 2021, all patients admitted to our hospital were screened by polymerase-chain-reaction (PCR) test for genetic material of SARS-CoV2. During this period, aSAH and symptomatic cerebral aneurysms were assessed and retrospectively compared to a historic longitudinal case-cohort.
Of 109.927 PCR-tests, 7.856 (7.15%) revealed a SARS-CoV2-infection. None of the patients mentioned above were tested positively. The number of aSAH and symptomatic aneurysms rose by 20.5% (39 vs. 47 cases) (p = 0.93). Poor grade aSAH, as well as extensive bleeding-patterns were more often observed (p = 0.63 and p = 0.40, respectively), with more symptomatic vasospasms diagnosed (5 vs. 9 patients). Mortality rate increased by 8,4%.
A correlation between SARS-CoV2-infection and the incidence of aSAH could not be established. Still, the overall number and the number of poor-grade aSAHs increased as well as symptomatic aneurysms during the pandemic. Therefore, we might conclude that dedicated neurovascular competence should be retained in designated centers to care for these patients even or especially in special situations affecting the global healthcare system.
在新冠疫情期间，据报道各类医疗急症显著减少了高达13%。预计动脉瘤性蛛网膜下腔出血（aSAH）和/或有症状的动脉瘤也会出现类似趋势。
分析SARS-CoV-2感染与aSAH发病率之间的相关性，并评估疫情封锁对aSAH和/或动脉瘤患者的发病率、结局及病程的影响。
从2020年3月16日（德国首次封锁）至2021年1月31日，对我院收治的所有患者进行聚合酶链反应（PCR）检测，以筛查SARS-CoV-2的遗传物质。在此期间，对aSAH和有症状的脑动脉瘤进行评估，并与历史纵向病例队列进行回顾性比较。
在109927次PCR检测中，7856次（7.15%）检测出SARS-CoV-2感染。上述患者均未检测呈阳性。aSAH和有症状动脉瘤的数量增加了20.5%（39例对47例）（p = 0.93）。更常观察到低分级aSAH以及广泛的出血模式（分别为p = 0.63和p = 0.40），诊断出更多有症状的血管痉挛（5例对9例患者）。死亡率增加了8.4%。
无法确定SARS-CoV-2感染与aSAH发病率之间的相关性。尽管如此，在疫情期间，aSAH的总数、低分级aSAH的数量以及有症状动脉瘤的数量均有所增加。因此，我们可以得出结论，即使在影响全球医疗系统的特殊情况下，尤其是在这种情况下，指定中心仍应保留专门的神经血管治疗能力，以照顾这些患者。
