Subarachnoid hemorrhages and aneurysms during the SARS-CoV2-pandemia at a tertiary medical center - Analysis of incidence and outcome

Konstantinos Lintas; Stefan Rohde; Gisa Ellrichmann; Boris El-Hamalawi; Robert Sarge; Oliver Müller

doi:10.1016/j.bas.2023.101757

Subarachnoid hemorrhages and aneurysms during the SARS-CoV2-pandemia at a tertiary medical center - Analysis of incidence and outcome

Brain Spine. 2023:3:101757. doi: 10.1016/j.bas.2023.101757. Epub 2023 May 11.

Authors

Konstantinos Lintas¹, Stefan Rohde², Gisa Ellrichmann³, Boris El-Hamalawi¹, Robert Sarge¹, Oliver Müller¹

Affiliations

¹ Neurosurgical Department, Dortmund Hospital, Germany.
² Radiological and Neuroradiological Department, Dortmund Hospital, Germany.
³ Neurological Department, Dortmund Hospital, Germany.

Abstract

Introduction: During the COVID-19-pandemic a significant decrease of up to 13% of all kinds of medical emergencies was reported. Similar trends were expected for aneurysmal subarachnoid hemorrhages (aSAH) and/or symptomatic aneurysms.

Research question: To analyze a correlation of the SARS-CoV2-infection and the incidence of aSAH, and to assess the impact of the pandemic-lockdown on the incidence, the outcome and the course of patients suffering from aSAH and/or aneurysms.

Material and methods: From March 16th, 2020 (first lockdown in Germany) to January 31st, 2021, all patients admitted to our hospital were screened by polymerase-chain-reaction (PCR) test for genetic material of SARS-CoV2. During this period, aSAH and symptomatic cerebral aneurysms were assessed and retrospectively compared to a historic longitudinal case-cohort.

Results: Of 109.927 PCR-tests, 7.856 (7.15%) revealed a SARS-CoV2-infection. None of the patients mentioned above were tested positively. The number of aSAH and symptomatic aneurysms rose by 20.5% (39 vs. 47 cases) (p = 0.93). Poor grade aSAH, as well as extensive bleeding-patterns were more often observed (p = 0.63 and p = 0.40, respectively), with more symptomatic vasospasms diagnosed (5 vs. 9 patients). Mortality rate increased by 8,4%.

Discussion and conclusion: A correlation between SARS-CoV2-infection and the incidence of aSAH could not be established. Still, the overall number and the number of poor-grade aSAHs increased as well as symptomatic aneurysms during the pandemic. Therefore, we might conclude that dedicated neurovascular competence should be retained in designated centers to care for these patients even or especially in special situations affecting the global healthcare system.

Keywords: Corona pandemic; N.I.N.E.; Subarachnoid hemorrhage; Symptomatic aneurysms.