Manifestations and Outcomes of Intracerebral Hemorrhage During the COVID-19 Pandemic in China: Multicenter, Longitudinal Cohort Study

Authors

Yan Wan, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Quan Wei He, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Shaoli Chen, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Man Li, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Yuanpeng Xia, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Lei Zhang, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Zhou Sun, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Xiaolu Chen, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
David Wang, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States.Follow
Jiang Chang, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Bo Hu, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Document Type

Article

Abstract

BACKGROUND: The COVID-19 pandemic has inevitably affected the distribution of medical resources, and epidemic lockdowns have had a significant impact on the nursing and treatment of patients with other acute diseases, including intracerebral hemorrhage (ICH). OBJECTIVE: This study aimed to investigate how the COVID-19 pandemic affected the manifestations and outcomes of patients with ICH. METHODS: Patients with acute ICH before (December 1, 2018-November 30, 2019) and during (December 1, 2019-November 30, 2020) the COVID-19 pandemic at 31 centers in China from the Chinese Cerebral Hemorrhage: Mechanism and Intervention (CHEERY) study were entered into the analysis. Demographic information and clinical manifestations and outcomes were collected and compared between the 2 groups. RESULTS: From December 1, 2018, to November 30, 2020, a total of 3460 patients with ICH from the CHEERY study were enrolled and eventually analyzed. The results showed that during the COVID-19 pandemic, patients with ICH were more likely to be older (P<.001) with a history of ischemic stroke (P=.04), shorter time from onset to admission (P<.001), higher blood pressure (P<.001), higher fasting blood glucose (P=.003), larger hematoma volume (P<.001), and more common deep ICH (P=.01) and intraventricular hemorrhage (P=.02). These patients required more intensive care unit treatment (P<.001) and preferred to go to the hospital directly rather than call an ambulance (P<.001). In addition, the COVID-19 pandemic was associated with an increased risk of pulmonary infection during hospitalization (adjusted risk ratio [RR] 1.267, 95% CI 1.065-1.509), lower probability of a 3-month good outcome (RR 0.975, 95% CI 0.956-0.995), and a higher probability of in-hospital (RR 3.103, 95% CI 2.156-4.465), 1-month (RR 1.064, 95% CI 1.042-1.087), and 3-month (RR 1.069, 95% CI 1.045-1.093) mortality. CONCLUSIONS: Our study indicated that the cloud of COVID-19 has adversely impacted the presentation and outcomes of ICH. Medical workers may pay more attention to patients with ICH, while the public should pay more attention to hypertension control and ICH prevention. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR1900020872; https://www.chictr.org.cn/showprojEN.html?proj=33817.

Medical Subject Headings

Humans; Longitudinal Studies; Pandemics; COVID-19 (epidemiology); Communicable Disease Control; Cerebral Hemorrhage (epidemiology); Cohort Studies; China (epidemiology)

Publication Date

12-13-2023

Publication Title

JMIR public health and surveillance

E-ISSN

2369-2960

Volume

9

First Page

e34386

PubMed ID

38090794

Digital Object Identifier (DOI)

10.2196/34386

Recommended Citation

Wan, Yan; He, Quan Wei; Chen, Shaoli; Li, Man; Xia, Yuanpeng; Zhang, Lei; Sun, Zhou; Chen, Xiaolu; Wang, David; Chang, Jiang; and Hu, Bo, "Manifestations and Outcomes of Intracerebral Hemorrhage During the COVID-19 Pandemic in China: Multicenter, Longitudinal Cohort Study" (2023). Neurology. 1802.
https://scholar.barrowneuro.org/neurology/1802