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Lang, Corinna N.; Dettinger, Johanna S.; Berchtold-Herz, Michael; Utzolino, Stefan; Bemtgen, Xavier; Zotzmann, Viviane; Schmid, Bonaventura; Biever, Paul M.; Bode, Christoph; Müller-Peltzer, Katharina; Duerschmied, Daniel; Wengenmayer, Tobias; Niesen, Wolf-Dirk; Staudacher, Dawid L.

Intracerebral Hemorrhage in COVID-19 Patients with Pulmonary Failure: A Propensity Score-Matched Registry Study

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  • Medientyp: E-Artikel
  • Titel: Intracerebral Hemorrhage in COVID-19 Patients with Pulmonary Failure: A Propensity Score-Matched Registry Study
  • Beteiligte: Lang, Corinna N.; Dettinger, Johanna S.; Berchtold-Herz, Michael; Utzolino, Stefan; Bemtgen, Xavier; Zotzmann, Viviane; Schmid, Bonaventura; Biever, Paul M.; Bode, Christoph; Müller-Peltzer, Katharina; Duerschmied, Daniel; Wengenmayer, Tobias; Niesen, Wolf-Dirk; Staudacher, Dawid L.
  • Erschienen: Springer Science and Business Media LLC, 2021
  • Erschienen in: Neurocritical Care, 34 (2021) 3, Seite 739-747
  • Sprache: Englisch
  • DOI: 10.1007/s12028-021-01202-7
  • ISSN: 1541-6933; 1556-0961
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: AbstractBackgroundHypercoagulability in Coronavirus Disease 2019 (COVID-19) causes deep vein thrombosis and pulmonary embolism necessitating systemic anticoagulation. Case reports of intracerebral hemorrhages in ventilated COVID-19 patients warrant precaution. It is unclear, however, if COVID-19 patients with acute respiratory distress syndrome (ARDS) with or without veno-venous extracorporeal membrane oxygenation therapy (VV-ECMO) have more intracerebral hemorrhages (ICH) compared to other ARDS patients.MethodsWe conducted a retrospective observational single-center study enrolling all patients with ARDS from 01/2018 to 05/2020. PCR-positive SARS-CoV-2 patients with ARDS were allocated to the COVID-19 group. Propensity score matching was performed for age, VV-ECMO, and bleeding risk.ResultsA total of 163 patients with moderate or severe ARDS were identified, 47 (28.8%) in the COVID-19 group, and 116 (71.2%) in the non-COVID-19 group. In 63/163 cases (38.7%), VV-ECMO therapy was required. The ICU survival was 52.8%. COVID-19 patients were older, more often male, and exhibited a lower SOFA score, but the groups showed similar rates of VV-ECMO therapy. Treatments with antiplatelet agents (p = 0.043) and therapeutic anticoagulation (p = 0.028) were significantly more frequent in the COVID-19 patients. ICH was detected in 22 patients (13.5%) with no statistical difference between the groups (11.2 vs. 19.1% without and with SARS-CoV-2, respectively,p = 0.21). Propensity score matching confirmed similar rates of ICH in both groups (12.8 vs. 19.1% without and with SARS-CoV-2, respectively,p = 0.57), thus leveling out possible confounders.ConclusionsIntracerebral hemorrhage was detected in every tenth patient with ARDS. Despite statistically higher rates of antiplatelet therapy and therapeutic anticoagulation in COVID-19 patients, we found a similar rate of ICH in patients with ARDS due to COVID-19 compared to other causes of ARDS.