Ümit GÖRGÜLÜ, Mustafa Harun ŞAHİN, Hesna BEKTAŞ

Covid-19 Enfeksiyonunda Akut İnme: Nöroloji Yoğun Bakım Deneyimi

Amaç: Coronavirus hastalığı 2019 (Covid-19), inme gibi trombotik olaylardaki artışla ilişkilendirilmiştir. Bu çalışmanın amacı, Covid-19'un inme hastalarının klinik, laboratuvar ve prognoz sonuçları üzerine etkisini araştırmaktır.Materyal-Metot: 1 Eylül 2020-30 Ocak 2021 tarihleri arasında Nöroloji Yoğun Bakım Ünitesinde tedavi gören akut inme ve Covid-19 birlikteliği olan hastalar retrospektif olarak çalışmaya dahil edildi. Hastaların demografik özellikleri, tıbbi komorbiditeleri, nörolojik semptomları, inme risk faktörleri, inme şiddeti, laboratuvar test sonuçları, görüntülemeleri ve hastane sonuçları kaydedildi. Bulgular: Nöroloji yoğun bakımda tedavi edilen 287 Covid-19 hasta dosyası retrospektif olarak incelendi ve 20 hasta çalışmaya dahil edildi. Hastaların yaş ortalaması 72,9 ± 16 (31-95), cinsiyetleri 11 erkek (%55) ve 9 kadındı (%45). 9 hasta inme geçirmeden önce Covid-19 enfeksiyonu tanısı almıştı, 11 hastada (%55) ise başvuru sırasında RT-PCR test ile (Real-time reverse transcription polymerase chain reaction) Covid-19 enfeksiyonu teşhisi konuldu. 18 hastada iskemik inme, 2 hastada intraserebral kanama vardı. Başvuru sırasında 13 (%65) hastada National Institutes of Health Stroke Scale Scoress koruna göre orta şiddette inme tespit edildi. En sık başvuru şikayetleri, hemiparezi veya hemipleji (%85), konuşma bozukluğu (%60) ve bilinç bozukluğuydu (%60). Hipertansiyon (%75), diyabetes mellitus (%35), koroner arter hastalığı (%30) en sık eşlik eden komorbit hastalıklardı. Hastalarda prokalsitonin, C-reaktif protein, eritrosit sedimentasyon hızı, interlökin-6, D-dimer, fibrinojen, laktatdehidrogenaz, total bilirubin yüksekliği ve düşük lenfosit seviyeleri mevcuttu. Vaka ölüm oranı %30’du.Sonuç: Covid-19 komorbid hastalığı olan yaşlılarda iskemik inme riskini artırır.

Anahtar Kelimeler:

Covid-19, inme, iskemik inme, hemorajik inme, mortalite

Acute Stroke in Covid-19 Infection: Neurology Intensive Care Experience

Objective: Coronavirus disease 2019 (Covid-19) has been related to an increase in thrombotic events such as stroke. The purpose of this study was to search the effect of Covid-19 on clinical, laboratory parameters, and outcomes in stroke patients.Material-Method: Patients with acute stroke and Covid 19 who were treated in the Neurology Intensive Care Unit between September 1, 2020 and January 30, 2021 were included in the study retrospectively. Patients' demographics, medical comorbidities, neurological symptoms, stroke risk factors, stroke severity, laboratory test results, imagings, as well as hospital outcomes were all investigated.Results: 287 Covid-19 patients treated in the neurology intensive care unit were reviewed retrospectively, and 20 patients were included in the study. The meanage of the patients was 72.9 ± 16 (31-95) years-old with 11 males (55 %) and 9 females (45 % ). 9 patients had a pre-stroke diagnosis of Covid-19 infection, 11 patients (55%) were diagnosed with Covid-19 infectionby RT-PCR test (Real-time reverse transcription polymerase chain reaction) at admission. 18 patients had ischemic stroke and 2 patients had intracerebral hemorrhage. Moderate stroke was detected in 13 (65%) patients at admission according to National Institutes of Health Stroke Scale Scores . The most common complaints at presentation were hemiparesis or hemiplegia (85%), speech disorder (60%), and impaired consciousness (60%). Hypertension (75%), diabetes mellitus (35%), coronary artery disease (30%) were the most common comorbid diseases. The patients had high procalcitonin, C-Reaktif protein, erythrocyte sedimentation rate, interleukin-6, d-dimer, fibrinogen, lactate dehydrogenase and low lymphocyte levels. The mortality rate was 30%.Conclusion: Covid-19 increases the risk of ischemic stroke in the elderly with comorbid disease.

Keywords:

Covid-19, stroke, ischemic Stroke, hemorrhagic stroke, mortality,

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