Intracranial hemorrhage in critically ill patients hospitalized for COVID-19.
Intracranial hemorrhage in critically ill patients hospitalized for COVID-19.
- 2020
In this study, we report three cases of spontaneous intracranial hemorrhage in patients who were initially hospitalized at our tertiary care center in Washington, DC with symptoms of COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed in all three patients, who were critically ill, requiring intubation and ventilatory support. During their protracted hospitalizations, subsequent imaging disclosed intracranial hemorrhages, including intracerebral and subarachnoid hemorrhages, in the context of anticoagulation and coagulopathy. We believe this is related to the tropism of SARS-CoV-2 to the endothelial lining of the cerebral vasculature via their angiotensin-converting enzyme (ACE) II receptors. Given our findings, we advocate heightened vigilance for intracerebral hemorrhage events, and scanning when practicable, in COVID-19 patients which have prolonged ventilatory support and depressed neurologic examinations. Copyright (c) 2020. Published by Elsevier Ltd.
English
0967-5868
10.1016/j.jocn.2020.08.026 [doi] PMC7434499 [pmc] S0967-5868(20)31467-3 [pii]
*Cerebral Hemorrhage/vi [Virology]
*COVID-19/co [Complications]
Aged
Critical Illness
Female
Hospitalization
Humans
Male
Middle Aged
SARS-CoV-2
MedStar Washington Hospital Center
Neurosurgery
Surgical Critical Care
Case Reports
Journal Article
In this study, we report three cases of spontaneous intracranial hemorrhage in patients who were initially hospitalized at our tertiary care center in Washington, DC with symptoms of COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was diagnosed in all three patients, who were critically ill, requiring intubation and ventilatory support. During their protracted hospitalizations, subsequent imaging disclosed intracranial hemorrhages, including intracerebral and subarachnoid hemorrhages, in the context of anticoagulation and coagulopathy. We believe this is related to the tropism of SARS-CoV-2 to the endothelial lining of the cerebral vasculature via their angiotensin-converting enzyme (ACE) II receptors. Given our findings, we advocate heightened vigilance for intracerebral hemorrhage events, and scanning when practicable, in COVID-19 patients which have prolonged ventilatory support and depressed neurologic examinations. Copyright (c) 2020. Published by Elsevier Ltd.
English
0967-5868
10.1016/j.jocn.2020.08.026 [doi] PMC7434499 [pmc] S0967-5868(20)31467-3 [pii]
*Cerebral Hemorrhage/vi [Virology]
*COVID-19/co [Complications]
Aged
Critical Illness
Female
Hospitalization
Humans
Male
Middle Aged
SARS-CoV-2
MedStar Washington Hospital Center
Neurosurgery
Surgical Critical Care
Case Reports
Journal Article