Association of Covid 19 Infection with Spontaneous Subarachnoid Hemorrhage in ICU Patients

Abstract

Background

Covid-19 infection may necessitate ICU admission and mechanical ventilation support due to acute respiratory failure. Apart from respiratory decompensation, neurological manifestations are found to be quite common.

Objective

The aim of this study is to evaluate the association of spontaneous subarachnoid hemorrhage and factors related to it.

Study Design

This retrospective observational study was conducted from February 2020 to August 2022 at Intensive care unit, The Children’s Hospital and Institute of Child Health, Faisalabad.

Results

During pandemic, out of 563 covid 19 ICU patients on mechanical ventilator, 48 patients developed subarachnoid hemorrhage at our setup. (n=48, 8.5%, 95% CI [2.43-4.95], RR=0.76) The levels of inflammatory markers were in congruence with the severity of the disease (P < 0.037). Out of 48 patients, 29 patients had comorbidities, 21 patients fully recovered without any deficit and 5 patients died.

Conclusion

Subarachnoid hemorrhage is one of the common manifestations of covid 19 infection. CSF analysis is found more sensitive than CT brain plain to detect (grade 1) subarachnoid hemorrhage. The severity of covid infection and development of associated subarachnoid hemorrhage was significantly related to the presence of pre-existing comorbidities, and the extent of hematological and CSF profile derangement. However, the relation between the duration of hospital stays, severity/duration of covid 19 and subarachnoid hemorrhage is found insignificant.

Keywords

Neurocovid, covid-19, subarachnoid hemorrhage, pediatrics, pathophysiology, mechanical ventilation