Engineering

Intracerebral hemorrhage

Biology

Neurosurgery

Surgery

Psychiatry

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

Neurology

Coronavirus disease 2019 (COVID-19)

Mechanical engineering

Intraventricular hemorrhage

Genetics

Pediatrics

Physics

Neuroradiology

Stroke (engine)

Optics

Gestational age

Infectious disease (medical specialty)

Internal medicine

Intraparenchymal hemorrhage

Epidemiology

Medicine

Pandemic

Subarachnoid hemorrhage

Disease

Incidence (geometry)

Mortality rate

Pregnancy

Neurological Sciences

Emerging evidence suggests that a subset of coronavirus disease 2019 (COVID-19) patients may present with or develop cerebrovascular disease during the course of hospitalization. Whereas ischemic stroke in COVID-19 patients has been well described, data on intracranial hemorrhage (ICH) in these patients is still limited. We, therefore, conducted a rapid systematic review of current scientific literature to identify and consolidate evidence of ICH in COVID-19 patients. A systematic search of literature was conducted between November 1, 2019, and August 14, 2020, on PubMed and China National Knowledge Infrastructure (CNKI) to identify eligible studies. A total of 23 studies describing ICH in 148 COVID-19 patients were included. The pooled incidence of ICH in COVID-19 patients was 0.7% (95% CI 0.5–0.9), with low levels of inter-study heterogeneity observed (I2 = 33.6%, Cochran's Q = 12.05, p = 0.149). Most of the patients were elderly male patients (65.8%) with comorbidities, the most common being systemic hypertension (54%). Hemorrhage involving multiple cranial compartments was reported in 9.5% of cases. Single compartments were involved in the rest, with intraparenchymal hemorrhage (IPH) being the most common variety (62.6%) and intraventricular hemorrhage (IVH) the least common (1.4%). Half of these patients were on some form of anticoagulation. Overall, the mortality rate in the COVID-19 patients with ICH was about 48.6%. Although relatively uncommon among COVID-19 patients, ICH is associated with a high mortality rate. Early identification of patients at risk of developing ICH, particularly with comorbid conditions and on anticoagulant therapy, may be important to improve outcomes.

Intracranial hemorrhage in coronavirus disease 2019 (COVID-19) patients