Etiopathogenetic factors and the course of hemorrhagic stroke associated with COVID-19

Background. Acute stroke is a highly specific neurological symptom in the acute phase of COVID-19. Hemorrhagic stroke (HS) is an infrequent, but life-threatening complication of COVID-19.Objective. To analyze etiopathogenetic factors and the course of HS associated with COVID-19.Design and methods. A retrospective analysis of 27 medical histories of patients with HS associated with COVID-19 (the main group) and 14 medical histories of patients with HS not related to COVID-19 (the control group) was performed. In the main group, COVID-19 was confirmed by the positive polymerase chain reaction method. HS developed before COVID-19 symptoms in 10 (37,04%) patients and after 4–16 days of COVID-19 symptoms onset in 17 (62,96%) patients.Results. Our study indicates significant differences in blood pressure (BP), respiratory system parameters, laboratory data, neuroimaging data in patients of the main and control groups. Coagulopathy, thrombocytopenia, hypoxia, and the renal and hepatic failure play a significant role in the development of HS associated with COVID-19 compared to the classic HS (without COVID-19), where hypertension seems to be the important. At the same time BP is significantly lower in the main group.Conclusions. The etiopathogenetic factors and the course of HS associated with COVID-19 require pathogenetically different therapy compared to HS without COVID-19.