İntrakranial Hemoraji ve SARS-CoV-2 Birlikteliğinin Mortalite Üzerine Etkisi

Amaç: SARS-CoV-2 dünyamızda hala yüksek mortalite ve morbiditeye neden olan bir pandemidir. SARS-CoV-2'nin akciğer ve diğer organ tutulumuna bağlı yüksek mortalite ve morbidite oranlarınının eşlik eden intrakraniyal olaylar varlığında daha da fazla olduğunu gözlemledik ve incelemek istedik. Yöntemler: Bu çalışma tek merkezli retrospektif bir kohort çalışmasıdır. Afyonkarahisar Devlet Hastanesi'ne Haziran 2020-Haziran 2021 tarihleri arasında başvuran, mevcut haliyle SARS-CoV-2 olarak değerlendirilen ve kafa içi kanaması tespit edilen hastalar değerlendirildi. Bulgular: Kohortumuzdaki 13 hastanın 7'sinde (%54) hipertansiyon, diabetes mellitus ve kronik böbrek yetmezliği gibi komorbiditeler vardı. Beş hastada intraparankimal hematom, 2 hastada kronik subdural hematom, 1 hastada akut subdural hematom ve 4 hastada subaraknoid kanama görüldü. Çalışmamızda 5 hastaya dekompresif kraniektomi ve hematom cerrahisi yapıldı. Çalışmamıza dahil edilen hastalardan dokuzu yoğun bakım ünitesindeki takip ve tedavileri sonucunda kaybedildi ve ölüm oranı %69 olarak bulundu. Sonuç: SARS-CoV-2 enfeksiyonu olan hastalarda nadiren intrakraniyal kanamalar oluşabilmekte ve zaten oldukça ölümcül olan intraserebral kanamaların daha ölümcül olduğu gözlemlenmektedir. Ayrıca COVID-19 enfeksiyonunun kafa içi kanamalar için bir risk faktörü olduğu düşünülmektedir.

The Effect of Intracranial Hemorrhage and SARS-CoV-2 Association on Mortality

Objective: SARS-CoV-2 is a pandemic that still causes high mortality and morbidity in our world. We observed and wanted to examine the high mortality and morbidity rates of SARS-CoV-2 due to lung and other organ involvement, and even more mortality in the presence of accompanying intracranial events.Methods: This study is a single-center retrospective cohort study. Patients who applied to Afyonkarahisar State Hospital between June 2020 and June 2021, who were evaluated as SARS-CoV-2 in their current state and who were found to have an intracranial hemorrhage, were evaluated.Results: Of the 13 patients in our cohort, 7 (54%) had comorbidities such as hypertension, diabetes mellitus, and chronic renal failure. The intraparenchymal hematoma was observed in 5 patients, chronic subdural hematoma in 2 patients, acute subdural hematoma in 1 patient, and subarachnoid hemorrhage in 4 patients. Decompressive craniectomy and hematoma evacuation were performed on 5 patients in our study. Nine of the patients included in our study died as a result of their follow-up and treatment in the intensive care unit, and the mortality rate was 69%.Conclusion: Intracranial hemorrhages may occur rarely in patients with SARS-CoV-2 infection, and it is observed that intracerebral hemorrhages, which are already quite mortal, are more mortal. In addition, COVID-19 infection is thought to be a risk factor for intracranial hemorrhages.

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