Computed tomography features of cerebrovascular complications in intensive care unit patients with severe COVID-19

Alves, Vinícius de Padua Vieira; Altoé, Ananda; Veloso, Vanessa; Ferreira, Clecia Lucia Santos; Ventura, Nina; Corrêa, Diogo Goulart

doi:10.1590/0100-3984.2021.0023

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Radiol Bras 54 (05) • Sep-Oct 2021 • https://doi.org/10.1590/0100-3984.2021.0023 copy

Computed tomography features of cerebrovascular complications in intensive care unit patients with severe COVID-19

Alterações na tomografia computadorizada das complicações cerebrovasculares em pacientes com COVID-19 grave na unidade de terapia intensiva

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To report the computed tomography (CT) features of acute cerebrovascular complications in severely ill patients with confirmed coronavirus disease 2019 (COVID-19) in the intensive care unit.

Materials and Methods:

We conducted a retrospective analysis of 29 intensive care unit patients with confirmed COVID-19 who underwent CT of the brain. We describe the CT features of the cerebrovascular complications of COVID-19, as well the demographic characteristics and clinical features, together with the results of laboratory tests, such as complete blood cell count, coagulation testing, renal function testing, and C-reactive protein assay.

Results:

Two patients were excluded because of brain death. Among the remaining 27 patients, CT revealed acute cerebrovascular complications in six (three men and three women; 49-81 years of age), whereas no such complications were seen in 21 (15 men and six women; 36-82 years of age).

Conclusion:

Radiologists should be aware of the risks of cerebrovascular complications of COVID-19 and the potential underlying etiologies. COVID-19-associated coagulopathy is likely multifactorial and may increase the risk of ischemic and hemorrhagic infarction.

Keywords:
Coronavirus infections/complications; Cerebrovascular disorders; Blood coagulation disorders; Tomography, X-ray computed

Characteristic	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5	Patient 6
Age	80	81	56	56	49	61
Sex	Female	Male	Male	Female	Male	Female
Comorbidities	Arterial hypertension, diabetes mellitus, heart disease, atrial fibrillation, and previous ischemic stroke	None	None	Arterial hypertension and diabetes mellitus	None	Arterial hypertension and obesity
Mechanical ventilation required	Yes	Yes	Yes	Yes	Yes	Yes

Variable	Group		P
Variable	w/CVC (n = 6)	w/oCVC (n = 21)	P
Age (years), mean ± SD	63.83 ± 13.46	58.85 ± 12.53	0.48^* * Mann-Whitney test;
Sex, n (%)
Male	3 (50.0)	15 (71.4)	0.36^† † Fisher's exact test.
Female	3 (50.0)	6 (28.6)
Leukocytes (cells/μL), mean ± SD	22116.66 ± 7242.87	15328.57 ± 6578.12	0.04^* * Mann-Whitney test;
Neutrophils (cells/μL), mean ± SD	15880.00 ± 4234.61	11649.19 ± 5429.54	0.06^* * Mann-Whitney test;
Lymphocytes (cells/μL), mean ± SD	2413.33 ± 1421.23	1542.23 ± 631.09	0.22^* * Mann-Whitney test;
Platelets (cells/μL), mean ± SD	224166.70 ± 154971.7	267142.90 ± 125903.6	0.19^* * Mann-Whitney test;
C-reactive protein (mg/L), mean ± SD	326.55 ± 242.55	213.83 ± 145.59	0.85^* * Mann-Whitney test;
Urea (mg/dL), mean ± SD	104.00 ± 40.76	63.14 ± 39.54	0.06^* * Mann-Whitney test;
Creatinine (mg/dL), mean ± SD	3.32 ± 1.77	1.71 ± 1.46	0.34^* * Mann-Whitney test;
Activated partial thromboplastin time (s), mean ± SD	27.51 ± 7.016	27.24 ± 4.91	0.92^* * Mann-Whitney test;
Prothrombin time (s), mean ± SD	19.70 ± 6.08	16.34 ± 3.85	0.26^* * Mann-Whitney test;
International normalized ratio, mean ± SD	1.55 ± 0.48	1.28 ± 0.31	0.26^* * Mann-Whitney test;
Mechanical ventilation required, n (%)
Yes	6 (100.0)	14 (66.7)	0.15^† † Fisher's exact test.
No	0 (0.0)	7 (33.3)

Publicação do Colégio Brasileiro de Radiologia e Diagnóstico por Imagem Av. Paulista, 37 - 7º andar - conjunto 71, 01311-902 - São Paulo - SP, Tel.: +55 11 3372-4541, Fax: 3285-1690, Fax: +55 11 3285-1690 - São Paulo - SP - Brazil
E-mail: radiologiabrasileira@cbr.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Correspondence: Dr. Vinícius de Padua Vieira Alves. Universidade Federal Fluminense. Avenida Marquês do Paraná, 303, Centro. Niterói, RJ, Brazil, 24033-900. Email: vinpvalves@gmail.com.