Cerebral hemorrhage

(HealthDay News) — Patients with acute ischemic stroke who also have COVID-19 have higher rates of intracranial bleeding complications and worse clinical outcomes following revascularization treatment than similar patients without COVID-19, according to a study published online Nov. 9 in Neurology.

João Pedro Marto, MD, from Hospital de Egas Moniz in Lisbon, Portugal, and colleagues examined the safety and outcomes of revascularization treatments in patients with acute ischemic stroke and COVID-19 in a retrospective cohort study. Consecutive patients with acute ischemic stroke receiving intravenous thrombolysis (IVT) and/or endovascular treatment (EVT) between March 2020 and June 2021, who were tested for severe acute respiratory syndrome coronavirus 2 infection, were included.

Among 15,128 patients from 105 centers, 853 were diagnosed with COVID-19. The researchers found that 5,848 patients (39%) received IVT only and 9,280 patients (61%) received EVT, with or without IVT. The rates of symptomatic intracerebral hemorrhage (SICH), symptomatic subarachnoid hemorrhage (SSAH), SICH and/or SSAH, and 24-hour and three-month mortality were increased for patients with COVID-19 (adjusted odds ratios, 1.53, 1.80, 1.56, 2.47, and 1.88, respectively). At three months, COVID-19 patients also had an unfavorable shift in the distribution of the modified Rankin score (odds ratio, 1.42).

“While our study found a higher rate of brain bleeds in people with COVID-19, the number of people who experienced complications was still small,” Marto said in a statement. “We believe treatments to restore blood flow remain beneficial to people with ischemic stroke and COVID-19 and suggest they continue to be given as quickly as possible using current treatment recommendations.”

Several authors disclosed financial ties to the pharmaceutical and medical device industry.

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