Patterns of acute ischemic stroke and intracranial hemorrhage in patients with COVID-19 : Results of a retrospective multicenter neuroimaging-based study from three central European countries

Media type: E-Article
Title: Patterns of acute ischemic stroke and intracranial hemorrhage in patients with COVID-19 : Results of a retrospective multicenter neuroimaging-based study from three central European countries : Results of a retrospective multicenter neuroimaging-based study from three central European countries
Contributor: Jensen-Kondering, Ulf; Maurer, Christoph J.; Brudermann, Hanna C. B.; Ernst, Marielle; Sedaghat, Sam; Margraf, Nils G.; Bahmer, Thomas; Jansen, Olav; Nawabi, Jawed; Vogt, Estelle; Büttner, Laura; Siebert, Eberhard; Bartl, Michael; Maus, Volker; Werding, Gregor; Schlamann, Marc; Abdullayev, Nuran; Bender, Benjamin; Richter, Vivien; Mengel, Annerose; Göpel, Siri; Berlis, Ansgar; Grams, Astrid; Ladenhauf, Valentin; [...]
imprint: Springer Science and Business Media LLC, 2023
Published in: Journal of Neurology
Language: English
DOI: 10.1007/s00415-023-11608-2
ISSN: 0340-5354; 1432-1459
Keywords: Neurology (clinical) ; Neurology
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Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>Coronavirus disease 2019 (COVID-19) is an infection which can affect the central nervous system. In this study, we sought to investigate associations between neuroimaging findings with clinical, demographic, blood and cerebrospinal fluid (CSF) parameters, pre-existing conditions and the severity of acute COVID-19.</jats:p> </jats:sec><jats:sec> <jats:title>Materials and methods</jats:title> <jats:p>Retrospective multicenter data retrieval from 10 university medical centers in Germany, Switzerland and Austria between February 2020 and September 2021. We included patients with COVID-19, acute neurological symptoms and cranial imaging. We collected demographics, neurological symptoms, COVID-19 severity, results of cranial imaging, blood and CSF parameters during the hospital stay.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>442 patients could be included. COVID-19 severity was mild in 124 (28.1%) patients (moderate <jats:italic>n</jats:italic> = 134/30.3%, severe <jats:italic>n</jats:italic> = 43/9.7%, critical <jats:italic>n</jats:italic> = 141/31.9%). 220 patients (49.8%) presented with respiratory symptoms, 167 (37.8%) presented with neurological symptoms first. Acute ischemic stroke (AIS) was detected in 70 (15.8%), intracranial hemorrhage (IH) in 48 (10.9%) patients. Typical risk factors were associated with AIS; extracorporeal membrane oxygenation therapy and invasive ventilation with IH. No association was found between the severity of COVID-19 or blood/CSF parameters and the occurrence of AIS or IH.</jats:p> </jats:sec><jats:sec> <jats:title>Discussion</jats:title> <jats:p>AIS was the most common finding on cranial imaging. IH was more prevalent than expected but a less common finding than AIS. Patients with IH had a distinct clinical profile compared to patients with AIS. There was no association between AIS or IH and the severity of COVID-19. A considerable proportion of patients presented with neurological symptoms first. Laboratory parameters have limited value as a screening tool.</jats:p> </jats:sec>

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