Intracranial compliance in patients with COVID-19: a multicenter observational study

• Published in: Arquivos de neuro-psiquiatria 2024-09, Vol.82 (9), p.1-8
• Main Authors: Silveira, Ana Flávia, Santos, Marcella Barreto, Collange, Nelci Zanon, Hayashi, Cintya Yukie, Vilela, Gustavo Henrique Frigieri, Almeida, Samantha Longhi Simões de, Andrade, João Brainer Clares de, Rojas, Salómon, Moraes, Fabiano Moulin de, Veiga, Viviane Cordeiro, Flato, Uri Adrian Prync, Russo, Thiago Luiz, Silva, Gisele Sampaio
• Format: Article
• Language: English
• Subjects: Acoplamento Neurovascular; Adult; Aged; Case-Control Studies; Cerebrovascular Circulation - physiology; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - physiopathology; Female; Hemodynamic Brain Response; Hemodynamics; Humans; Intracranial Hypertension - physiopathology; Intracranial Pressure; Intracranial Pressure - physiology; Male; Mechanical ventilation; Middle Aged; Monitorização Neurofisiológica; Neurological diseases; Neurophysiological Monitoring; NEUROSCIENCES; Observational studies; Pressão Intracraniana; PSYCHIATRY; Respiration, Artificial; SARS-CoV-2; Statistical analysis; Statistical models
• ISSN: 0004-282X; 1678-4227; 1678-4227
• DOI: 10.1055/s-0044-1788669

Patients with severe coronavirus disease-19 (COVID-19) may require the use of invasive mechanical ventilation (MV) for prolonged periods. Aggressive MV parameters have been associated with changes in intracranial pressure (ICP) in patients with acute intracranial disorders. Significant ICP elevation could compromise intracranial compliance (ICC) and cerebrovascular hemodynamics (CVH). However, the effects of these parameters in individuals without neurological disorders have not yet been evaluated.  To evaluate ICC in patients on MV with COVID-19 infection compared to other diagnoses, to better characterize the effects of MV and COVID-19 upon ICC. We also compared between the ICC in patients with COVID-19 who did not require MV and healthy volunteers, to assess the isolated effect of COVID-19 upon ICC.  This was an exploratory, observational study with a convenience sample. The ICC was evaluated with a noninvasive ICP monitoring device. The P2/P1 ratio was calculated by dividing the amplitude of these two points, being defined as "abnormal" when P2 > P1. The statistical analysis was performed using a mixed linear model with random effects to compare the P2/P1 ratio in all four groups on the first monitoring day.  A convenience sample of 78 subjects (15 MV-COVID-19, 15 MV non-COVID-19, 24 non-MV-COVID-19, and 24 healthy participants) was prospectively enrolled. There was no difference in P2/P1 ratios between MV patients with and without COVID-19, nor between non-MV patients with COVID-19 and healthy volunteers. However, the P2/P1 ratio was higher in COVID-19 patients with MV use than in those without it.  This exploratory analysis suggests that COVID-19 does not impair ICC.