Cerebral microhaemorrhage in COVID-19 : a critical illness related phenomenon?

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ..

BACKGROUND: Cerebral microhaemorrhages are increasingly being recognised as a complication of COVID-19. This observational retrospective study aims to further investigate the potential pathophysiology through assessing the pattern of microhaemorrhage and clinical characteristics of patients with COVID-19 and microhaemorrhage. By comparing with similar patterns of microhaemorrhage in other non-COVID-19 disease, this study aims to propose possible common pathogenic mechanisms.

METHODS: A retrospective observational case series was performed identifying all patients with COVID-19 complicated by cerebral microhaemorrhage on MRI. The distribution and number of microhaemorrhages were recorded using the microbleed anatomical scale, and patients' baseline characteristics and salient test results were also recorded.

RESULTS: Cerebral microhaemorrhages were noted to have a predilection for the corpus callosum, the juxtacortical white matter and brainstem. All patients had a preceding period of critical illness with respiratory failure and severe hypoxia necessitating intubation and mechanical ventilation.

DISCUSSION: This study demonstrates a pattern of cerebral microhaemorrhage that is similar to the pattern reported in patients with non-COVID-19 related critical illness and other causes of severe hypoxia. This raises questions regarding whether microhaemorrhage occurs from endothelial dysfunction due the direct effect of SARS-CoV-2 infection or from the secondary effects of critical illness and hypoxia.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:5

Enthalten in:

Stroke and vascular neurology - 5(2020), 4 vom: 31. Dez., Seite 315-322

Sprache:

Englisch

Beteiligte Personen:

Dixon, Luke [VerfasserIn]
McNamara, Cillian [VerfasserIn]
Gaur, Pritika [VerfasserIn]
Mallon, Dermot [VerfasserIn]
Coughlan, Christopher [VerfasserIn]
Tona, Francesca [VerfasserIn]
Jan, Wajanat [VerfasserIn]
Wilson, Mark [VerfasserIn]
Jones, Brynmor [VerfasserIn]

Links:

Volltext

Themen:

Blood flow
Brain
Haemorrhage
Infection
Inflammation
Journal Article
Observational Study
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 07.01.2021

Date Revised 10.01.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1136/svn-2020-000652

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM317756656