1. Accidente cerebrovascular hemorrágico asociado a infección por COVID-19 en Hospital General de México
- Author
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Ariatne Mar-Álvarez, Aldo F Hernández-Valencia, José Luis Navarro-Olvera, José D. Carrillo-Ruiz, Gustavo Parra-Romero, and Gustavo Aguado-Carrillo
- Subjects
Gynecology ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Poor prognosis ,Coronavirus disease 2019 (COVID-19) ,RD1-811 ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Cardiovascular risk factors ,Enfermedad cerebrovascular. Coagulopatía. COVID-19. Hemorragia cerebral. SARS-CoV-2 ,medicine.disease ,Pcr test ,medicine ,Surgery ,General hospital ,business ,Stroke - Abstract
Introduccion en la actual pandemia de COVID-19, existe evidencia creciente que ha identificado el neurotropismo del virus SARS-CoV-2 y sus complicaciones neurologicas, incluida la enfermedad cerebrovascular isquemica y escasamente hemorragia cerebral (HC). Objetivo describir las caracteristicas clinicas, radiologicas, de laboratorio y pronosticas de los pacientes con HC asociada al SARS-CoV-2. Metodos se incluyeron pacientes consecutivos con prueba de PCR confirmatoria para infeccion por SARS-CoV-2 y HC. Resultados en un periodo de 90 dias, en un centro de referencia COVID-19 en Mexico, de 1108 pacientes con infeccion por SARS-CoV-2, se encontraron 4 pacientes (0.36%) con HC. Tenian una edad de 71(±12.2) anos, 2 eran mujeres. Se encontro que dos tenian factores de riesgo cardiovascular previos. En dos casos se encontro el origen en el nucleo dentado mientras que los otros dos correspondieron al talamo. Tres de los cuatro pacientes murieron. Postulamos que el descontrol hipertensivo, coagulopatia, trombocitopenia y la respuesta inmune inducida por el virus SARS-CoV-2 podrian desencadenar HC en un paciente con riesgo previo. Conclusiones la HC se asocia a la infeccion por SARS-CoV-2 con mal pronostico cuando se presenta. Los equipos de neurocirugia deben estar preparados para el tratamiento oportuno de estos pacientes. Introduction In the current COVID-19 pandemic, there is a growing body of evidence that has identified the neurotropism of the SARS-CoV-2 virus and its neurological complications, including cerebrovascular disease, focusing mainly in ischemic and scarcely about hemorrhagic stroke (HS). Objective The objective of the study was to describe clinical, radiological, laboratory tests, and prognostic characteristics of patients with SARS-CoV-2 associated HS. Methods Consecutive patients with a confirmatory PCR test for SARS-CoV-2 infection and a HS demonstrated by head CT were included in the study. Results Over a period of 90 days, in a COVID-19 reference center in Mexico, out of a total of 1108 patients with SARS-CoV-2 infection, it found 4 patients (0.36%) who meet criteria. They had an age of 71 (±12.2) years, 2 were women. It was found that two had prior cardiovascular risk factors. Two of the HS originated in the dentate nucleus while the other two corresponded to the thalamus. Three of the four patients died. We suggest that catastrophic uncontrolled blood pressure, coagulopathy, thrombocytopenia, and immune response induced by SARS-CoV-2 could in a specific patient trigger HS. Conclusions HS is associated to SARS-CoV-2 infection with poor prognosis when it presented. Neurosurgery teams should prepare for the timely and appropriate treatment of this patients.
- Published
- 2021