About: Anticoagulation use and Hemorrhagic Stroke in SARS-CoV-2 Patients Treated at a New York Healthcare System

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About: Anticoagulation use and Hemorrhagic Stroke in SARS-CoV-2 Patients Treated at a New York Healthcare System Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Anticoagulation use and Hemorrhagic Stroke in SARS-CoV-2 Patients Treated at a New York Healthcare System
Creator	Gordon, David Zhou, Ting Nelson, Peter Frontera, Jennifer Czeisler, Barry Ishida, Koto Jain, Rajan Kvernland, Alexandra Lewis, Ariane Lord, Aaron Melmed, Kara Riina, Howard Tanweer, Omar Yaghi, Shadi Dehkharghani, Seena Henninger, Nils Kumar, Arooshi Nossek, Erez Raz, Eytan Shapiro, Maksim Torres, Jose De Havenon, Adam Kahn, D Grory, Brian
Source	Medline; PMC
abstract	BACKGROUND AND PURPOSE: While the thrombotic complications of COVID-19 have been well described, there are limited data on clinically significant bleeding complications including hemorrhagic stroke. The clinical characteristics, underlying stroke mechanism, and outcomes in this particular subset of patients are especially salient as therapeutic anticoagulation becomes increasingly common in the treatment and prevention of thrombotic complications of COVID-19. METHODS: We conducted a retrospective cohort study of patients with hemorrhagic stroke (both non-traumatic intracerebral hemorrhage and spontaneous non-aneurysmal subarachnoid hemorrhage) who were hospitalized between March 1, 2020, and May 15, 2020, within a major healthcare system in New York, during the coronavirus pandemic. Patients with hemorrhagic stroke on admission and who developed hemorrhage during hospitalization were both included. We compared the clinical characteristics of patients with hemorrhagic stroke and COVID-19 to those without COVID-19 admitted to our hospital system between March 1, 2020, and May 15, 2020 (contemporary controls), and March 1, 2019, and May 15, 2019 (historical controls). Demographic variables and clinical characteristics between the individual groups were compared using Fischer’s exact test for categorical variables and nonparametric test for continuous variables. We adjusted for multiple comparisons using the Bonferroni method. RESULTS: During the study period in 2020, out of 4071 patients who were hospitalized with COVID-19, we identified 19 (0.5%) with hemorrhagic stroke. Of all COVID-19 with hemorrhagic stroke, only three had isolated non-aneurysmal SAH with no associated intraparenchymal hemorrhage. Among hemorrhagic stroke in patients with COVID-19, coagulopathy was the most common etiology (73.7%); empiric anticoagulation was started in 89.5% of these patients versus 4.2% in contemporary controls (p ≤ .001) and 10.0% in historical controls (p ≤ .001). Compared to contemporary and historical controls, patients with COVID-19 had higher initial NIHSS scores, INR, PTT, and fibrinogen levels. Patients with COVID-19 also had higher rates of in-hospital mortality (84.6% vs. 4.6%, p ≤ 0.001). Sensitivity analyses excluding patients with strictly subarachnoid hemorrhage yielded similar results. CONCLUSION: We observed an overall low rate of imaging-confirmed hemorrhagic stroke among patients hospitalized with COVID-19. Most hemorrhages in patients with COVID-19 infection occurred in the setting of therapeutic anticoagulation and were associated with increased mortality. Further studies are needed to evaluate the safety and efficacy of therapeutic anticoagulation in patients with COVID-19.
has issue date	2020-08-24(xsd:dateTime)
bibo:doi	10.1007/s12028-020-01077-0
bibo:pmid	32839867
has license	no-cc
sha1sum (hex)	ac4ded02e199896df82be2273212f2b5c4fbc70e
schema:url	https://doi.org/10.1007/s12028-020-01077-0
resource representing a document's title	Anticoagulation use and Hemorrhagic Stroke in SARS-CoV-2 Patients Treated at a New York Healthcare System
has PubMed Central identifier	PMC7444897
has PubMed identifier	32839867
schema:publication	Neurocrit Care
resource representing a document's body	covid:ac4ded02e199896df82be2273212f2b5c4fbc70e#body_text
is schema:about of	named entity 'salient' named entity 'Stroke' named entity 'BLEEDING' named entity 'bleeding' named entity 'Background' named entity 'complications' named entity 'anticoagulation' named entity 'thrombotic complications' named entity 'subset' named entity 'COVID-19' named entity 'thrombotic complications' named entity 'SARS-CoV-2' named entity 'Anticoagulation' named entity 'anticoagulation' named entity 'angiogenesis' named entity 'subarachnoid hemorrhage' named entity 'low molecular weight heparin' named entity 'coagulopathy' named entity 'ischemic strokes' named entity 'National Institutes of Health Stroke Scale' named entity 'Coagulopathy' named entity 'sensitivity analysis' named entity 'anticoagulation therapy' named entity 'NYU' named entity 'human brains' named entity 'Hemorrhagic stroke' named entity 'disease processes' named entity 'hemorrhagic stroke' named entity 'anticoagulation' named entity 'platelet count' named entity 'hemorrhagic strokes' named entity 'anticoagulation' named entity 'infarcts' named entity 'SAH' named entity 'coagulopathy' named entity 'anticoagulation' named entity 'randomized controlled studies' named entity 'neurons' named entity 'thoracic' named entity 'left column' named entity 'etiology' named entity 'COVID-19' named entity 'platelet count' named entity 'COVID' named entity 'COVID-19' named entity 'Mineola' named entity 'SAH' named entity 'SAH' named entity 'Hydroxychloroquine' named entity 'Center for Disease Control' named entity 'infection' named entity 'SARS-CoV-2' named entity 'hypercoagulable state' named entity 'COVID' named entity 'medical records' named entity 'hemorrhagic stroke' named entity 'anticoagulation' named entity 'COVID'

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