Cerebral microhemorrhages in severe COVID-19 pneumonia

Surg Neurol Int. 2022 Aug 26;13:380. doi: 10.25259/SNI_605_2022. eCollection 2022.


Background: Cerebral microhemorrhages are a complication in patients with severe COVID-19 pneumonia.

Case description: A 50-year-old woman presented to the hospital with shortness of breath due COVID-19 (SARS-CoV-2, alpha variant) pneumonia. Her hospital course was complicated by hypoxic respiratory failure requiring intubation and severe acute respiratory distress syndrome. She received a tracheostomy for ongoing ventilator support after prolonged intubation. Her mental status was notable for disorientation and severe agitation for which a magnetic resonance imaging (MRI) of the brain was obtained. MRI revealed numerous microhemorrhages predominantly at the gray-white matter junctions.

Conclusion: Cerebral microhemorrhages in severe COVID-19 pneumonia are associated with critical illness, increased mortality, and worse functional outcome. The pathophysiology of cerebral microhemorrhages in COVID-19 is unknown.

Keywords: COVID-19; Cerebral microhemorrhages; Endotheliopathy; Hypoxia; SARS-CoV-2.

Publication types

  • Case Reports