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Risk factors for intracerebral hemorrhage in patients with COVID-19
- Source :
- Journal of Thrombosis and Thrombolysis
- Publication Year :
- 2020
-
Abstract
- Intracerebral hemorrhage (ICH) can be a devastating complication of coronavirus disease (COVID-19). We aimed to assess risk factors associated with ICH in this population. We performed a retrospective cohort study of adult patients admitted to NYU Langone Health system between March 1 and April 27 2020 with a positive nasopharyngeal swab polymerase chain reaction test result and presence of primary nontraumatic intracranial hemorrhage or hemorrhagic conversion of ischemic stroke on neuroimaging. Patients with intracranial procedures, malignancy, or vascular malformation were excluded. We used regression models to estimate odds ratios and 95% confidence intervals (OR, 95% CI) of the association between ICH and covariates. We also used regression models to determine association between ICH and mortality. Among 3824 patients admitted with COVID-19, 755 patients had neuroimaging and 416 patients were identified after exclusion criteria were applied. The mean (standard deviation) age was 69.3 (16.2), 35.8% were women, and 34.9% were on therapeutic anticoagulation. ICH occurred in 33 (7.9%) patients. Older age, non-Caucasian race, respiratory failure requiring mechanical ventilation, and therapeutic anticoagulation were associated with ICH on univariate analysis (p < 0.01 for each variable). In adjusted regression models, anticoagulation use was associated with a five-fold increased risk of ICH (OR 5.26, 95% CI 2.33–12.24, p < 0.001). ICH was associated with increased mortality (adjusted OR 2.6, 95 % CI 1.2–5.9). Anticoagulation use is associated with increased risk of ICH in patients with COVID-19. Further investigation is required to elucidate underlying mechanisms and prevention strategies in this population. Electronic supplementary material The online version of this article (10.1007/s11239-020-02288-0) contains supplementary material, which is available to authorized users.
- Subjects :
- Male
medicine.medical_specialty
Population
Neuroimaging
030204 cardiovascular system & hematology
Risk Assessment
Article
Cohort Studies
03 medical and health sciences
Anticoagulation
0302 clinical medicine
Mechanical ventilation
Risk Factors
Internal medicine
Medicine
Humans
030212 general & internal medicine
cardiovascular diseases
education
Aged
Cerebral Hemorrhage
Ischemic Stroke
Intracerebral hemorrhage
Univariate analysis
education.field_of_study
business.industry
SARS-CoV-2
Anticoagulants
COVID-19
Retrospective cohort study
Odds ratio
Hematology
medicine.disease
Respiration, Artificial
United States
Respiratory failure
Female
Complication
business
Hemorrhagic stroke
Cardiology and Cardiovascular Medicine
Respiratory Insufficiency
Cohort study
Subjects
Details
- ISSN :
- 1573742X
- Volume :
- 51
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Journal of thrombosis and thrombolysis
- Accession number :
- edsair.doi.dedup.....2aab1f5bfa86f6d85961ecc3912829a1