Intracerebral hemorrhage in COVID-19 patients with pulmonary failure – a propensity score matched registry study

Abstract Background: Hypercoagulopathy in coronavirus disease 2019 (COVID-19) causing deep vein thrombosis and pulmonary artery embolism necessitate 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 and without extracorporeal membrane oxygenation therapy (ECMO) have more intracerebral hemorrhages (ICH) compared to other ARDS patients.Methods: We conducted a retrospective observational single center study enrolling all patients with ARDS from 01/2018-05/2020. Patients with ARDS positive for SARS-CoV2 PCR were allocated to the COVID-19 group. Propensity score matching was performed for age, ECMO and risk of bleeding according to HAS-BLED score.Results: A total of 163, mostly severe ARDS patients were identified, 116 (71.2%) without COVID-19 and 47 (28.8%) positive for SARS-CoV-2. The two groups were comparable concerning the main confounders of ICH including age, HAS-BLED score, need for ECMO-therapy as well as anticoagulation levels reported. In 63/163 cases (38.7%), veno-venous ECMO therapy was required and ICU survival was 52.8%. Although HAS-BLED-score on admission was generally low (1.6±1.3), intracerebral hemorrhage was detected in 22 patients (13.5%) with no statistical difference between the groups (11.2 vs. 19.1% with and without SARS-CoV-2, respectively, p=0.21). Propensity score matching confirmed similar intracerebral bleeding rates in both groups (12.8 vs. 19.1% with and without SARS-CoV-2, respectively, p=0.57). Conclusions: Intracerebral hemorrhage was detectable in every tenth patient with ARDS. We found no statistically significant increased bleeding rate in patients with ARDS due to COVID-19 compared to other causes of ARDS..

Medienart:	Preprint

Erscheinungsjahr:	2022
Erschienen:	2022

Enthalten in:	ResearchSquare.com - (2022) vom: 28. Juli Zur Gesamtaufnahme - year:2022

Sprache:	Englisch

Beteiligte Personen:

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

Links:	Volltext [lizenzpflichtig] Volltext [kostenfrei]

Themen:	570 Biology

doi:	10.21203/rs.3.rs-56258/v1

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PPN (Katalog-ID):	XRA03343350X