Imaging features and ultraearly hematoma growth in intracerebral hemorrhage associated with COVID-19.

Intracerebral hemorrhage (ICH) is an uncommon but deadly event in patients with COVID-19 and its imaging features remain poorly characterized. We aimed to describe the clinical and imaging features of COVID-19-associated ICH. Multicenter, retrospective, case-control analysis comparing ICH in COVID-19 patients (COV19 +) versus controls without COVID-19 (COV19 -). Clinical presentation, laboratory markers, and severity of COVID-19 disease were recorded. Non-contrast computed tomography (NCCT) markers (intrahematoma hypodensity, heterogeneous density, blend sign, irregular shape fluid level), ICH location, and hematoma volume (ABC/2 method) were analyzed. The outcome of interest was ultraearly hematoma growth (uHG) (defined as NCCT baseline ICH volume/onset-to-imaging time), whose predictors were explored with multivariable linear regression. A total of 33 COV19 + patients and 321 COV19 - controls with ICH were included. Demographic characteristics and vascular risk factors were similar in the two groups. Multifocal ICH and NCCT markers were significantly more common in the COV19 + population. uHG was significantly higher among COV19 + patients (median 6.2 mL/h vs 3.1 mL/h, p = 0.027), and this finding remained significant after adjustment for confounding factors (systolic blood pressure, antiplatelet and anticoagulant therapy), in linear regression (B(SE) = 0.31 (0.11), p = 0.005). This association remained consistent also after the exclusion of patients under anticoagulant treatment (B(SE) = 0.29 (0.13), p = 0.026). ICH in COV19 + patients has distinct NCCT imaging features and a higher speed of bleeding. This association is not mediated by antithrombotic therapy and deserves further research to characterize the underlying biological mechanisms. © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Citation

Andrea Morotti, Andrea Pilotto, Valentina Mazzoleni, Enrico Fainardi, Ilaria Casetta, Anna Cavallini, Giulia Del Moro, Elisa Candeloro, Francesco Janes, Paolo Costa, Andrea Zini, Eleonora Leuci, Federico Mazzacane, Serena Magno, Oriela Rustemi, Fabio Raneri, Giuseppe Canova, Mariarosaria Valente, Andrea Giorgianni, Francesca Solazzo, Maurizio Versino, Marco Mauri, Mauro Gentile, Ludovica Migliaccio, Stefano Forlivesi, Eugenio Magni, Elisabetta Del Zotto, Alberto Benussi, Enrico Premi, Massimo Gamba, Loris Poli, Alessandro Pezzini, Roberto Gasparotti, Mauro Magoni, Stefano Gipponi, Alessandro Padovani. Imaging features and ultraearly hematoma growth in intracerebral hemorrhage associated with COVID-19. Neuroradiology. 2022 Jul;64(7):1367-1372

Mesh Tags

Substances

PMID: 35034151

search → result