TY - JOUR T1 - Cerebral microhaemorrhage in COVID-19: a critical illness related phenomenon? JF - Stroke and Vascular Neurology JO - Stroke Vasc Neurol DO - 10.1136/svn-2020-000652 VL - 5 IS - 4 SP - e000652 AU - Luke Dixon AU - Cillian McNamara AU - Pritika Gaur AU - Dermot Mallon AU - Charles Coughlan AU - Francesca Tona AU - Wajanat Jan AU - Mark Wilson AU - Brynmor Jones Y1 - 2020/12/01 UR - http://svn.bmj.com/content/5/4/e000652.abstract N2 - Background Cerebral microhaemorrhages are increasingly being recognised as a complication of COVID-19. This observational retrospective study aims to further investigate the potential pathophysiology through assessing the pattern of microhaemorrhage and clinical characteristics of patients with COVID-19 and microhaemorrhage. By comparing with similar patterns of microhaemorrhage in other non-COVID-19 disease, this study aims to propose possible common pathogenic mechanisms.Methods A retrospective observational case series was performed identifying all patients with COVID-19 complicated by cerebral microhaemorrhage on MRI. The distribution and number of microhaemorrhages were recorded using the microbleed anatomical scale, and patients’ baseline characteristics and salient test results were also recorded.Results Cerebral microhaemorrhages were noted to have a predilection for the corpus callosum, the juxtacortical white matter and brainstem. All patients had a preceding period of critical illness with respiratory failure and severe hypoxia necessitating intubation and mechanical ventilation.Discussion This study demonstrates a pattern of cerebral microhaemorrhage that is similar to the pattern reported in patients with non-COVID-19 related critical illness and other causes of severe hypoxia. This raises questions regarding whether microhaemorrhage occurs from endothelial dysfunction due the direct effect of SARS-CoV-2 infection or from the secondary effects of critical illness and hypoxia.All data relevant to the study are included in the article or uploaded as supplementary information. ER -