ORIGINAL

Aneurysmal Subarachnoid Hemorrhage in Covid-19 Patients Predicts Worst Clinical Presentation and Higher Mortality

Hemorragia Subaracnoidea Aneurismática em Pacientes com Covid-19 é Preditor de Pior Apresentação Clínica e Maior Mortalidade

  • Lucas Crociati Meguins (1)
  • Dionei Freitas de Morais (1)
  • Ricardo Lourenço Caramanti (2)
  • Carlos Eduardo Dall’Aglio Rocha (1)
  • Raquel Cristina Trovo Hidalgo (3)
  • Crescêncio Alberto Pereira Centola (3)
  • Eberval Gadelha Figueiredo (4)
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  Downloads: 23

Resumo

Objetivo: O objetivo do presente estudo é investigar as consequências da infecção do COVID-19 em pacientes com aneurisma roto. Métodos: A investigação foi realizada como um estudo observacional retrospectivo não randomizado. Resultados: No grupo de pacientes SARS-CoV-2-negativos, 166 (72,81%) foram admitidos com uma escala Hunt-Hess (HH) I-III (HH I: 5 [2,19%]/HH II: 111 [48,68%]/HH III: 50 [21,93%]) e 62 (27,19%) eram HH IV-V (HH IV: 55 [24,12%]/HH V: 7 [3,07%]). No total, 104 (45,61%) pacientes foram admitidos com pontuação na Escala de Coma de Glasgow (ECG) de 15 pontos, 46 (20,18%) com pontuação na GCS de 13-14 pontos, 56 (24,56%) com pontuação na GCS de 7-12 pontos e 22 (9,65%) com pontuação GCS de 3-6 pontos. No grupo de pacientes positivos para SARS-CoV-2, dois (18,18%) foram admitidos com pontuação na escala Hunt-Hess (HH) de I-III (HH I: 0 [0%]/HH II: 1 [ 9,09%]/HH III: 1 [9,09%]) e 9 (81,82%) pacientes tiveram uma pontuação de HH IV-V (HH IV: 4 [36,36%]/HH V: 5 [45,45%]). Um (9,09%) paciente foi admitido com GCS de 15 pontos, 3 (27,27%) com GCS de 13-14 pontos, 2 (18,18%) com GCS de 7-12 pontos e 5 (45,45%) com uma pontuação GCS de 3-6 pontos. No grupo de pacientes SARS-CoV-2-negativos, de todos os 228 indivíduos tratados, 138 (60,53%) tiveram uma pontuação modificada da Escala de Rankin (mRS) ≤3, 35 (15,35%) tiveram uma pontuação de mRS de 4-5, e 55 (24,12%) morreram. Por outro lado, no grupo de pacientes positivos para SARS-CoV-2, de todos os 11 indivíduos tratados, 2 (18,18%) tiveram pontuação mRS ≤3, 2 (18,18%) tiveram pontuação mRS de 4-5, e 7 (63,64%) morreram. Conclusão: COVID-19 tem a apresentação clínica mais grave e maior mortalidade em pacientes com HASa.



Palavras-chave

Hemorragia subaracnoidea aneurismática; COVID-19; Apresentação clínica; Mortalidade

Abstract

Objective: The aim of the present study is to identify the consequences of COVID-19 infetion and intracranial aneurysmal rupture. Methods: The investigation was performed as a nonrandomized retrospective observational study. Results: In the group of SARS-CoV- 2-negative patients, one hundred sixty-six (72.81%) were admitted with a Hunt-Hess (HH) Scale I-III (HH I: 5 [2.19%]/HH II: 111 [48.68%]/HH III: 50 [21.93%]) and 62 (27.19%) were HH IV-V (HH IV: 55 [24.12%]/HH V: 7 [3.07%]). In total, 104 (45.61%) patients were admitted with a Glasgow Coma Scale (GCS) score of 15 points, 46 (20.18%) with a GCS score of 13-14 points, 56 (24.56%) with a GCS score of 7-12 points and 22 (9.65%) with GCS score of 3-6 points. In the group of SARS-CoV-2-positive patients, two (18.18%) were admitted to with a Hunt-Hess (HH) Scale score of I-III (HH I: 0 [0%]/HH II: 1 [9.09%]/HH III: 1 [9.09%]), and 9 (81.82%) patients had a score of HH IV-V (HH IV: 4 [36.36%]/HH V: 5 [45.45%]). One (9.09%) patient was admitted with a GCS score of 15 points, 3 (27.27%) with a GCS score of 13-14 points, 2 (18.18%) with a GCS score of 7-12 points, and 5 (45.45%) with a GCS score of 3-6 points. In the group of SARS-CoV-2-negative patients, of all 228 individuals treated, 138 (60.53%) had a modified Rankin Scale (mRS) score ≤3, 35 (15.35%) had a mRS score of 4-5, and 55 (24.12%) died. On the other hand, in the group of SARS-CoV-2-positive patients, of all 11 individuals treated, 2 (18.18%) had a mRS score ≤3, 2 (18.18%) had a mRS score of 4-5, and 7 (63.64%) died. Conclusion: COVID-19 has the most severe clinical presentation and higher mortality in patients with aSAH.

Keywords

Aneurysmal subarachnoid hemorrhage; COVID-19; Clinical presentation; Mortality

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(1) MD, PhD, Neurosurgeon, Service of Neurosurgery, Hospital de Base, Fundação Faculdade Regional de Medicina de São José do Rio Preto – FUNFARME, São José do Rio Preto, SP, Brazil.

(2) MD, Neurosurgeon, Service of Neurosurgery, Hospital de Base, Fundação Faculdade Regional de Medicina de São José do Rio Preto – FUNFARME, São José do Rio Preto, SP, Brazil.

(3) MD, Neuroradiologist, Service of Interventional Neuroradiology, Hospital de Base, Fundação Faculdade Regional de Medicina de São José do Rio Preto – FUNFARME, São José do Rio Preto, SP, Brazil.

(4) MD, PhD, Neurosurgeon, Service of Neurosurgery, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo – FMUSP, São Paulo, SP, Brazil.

 

Received Apr 17, 2022

Accepted Apr 25, 2022


JBNC  Brazilian Journal of Neurosurgery

  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786

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