LAUSR

Objective The SARS-CoV-2 pandemic is a pressing public health issue. While most cases do not result in severe illness requiring hospitalization, there is increasing evidence that SARS-CoV-2-induced inflammation can exacerbate preexisting diseases. We sought to describe the characteristics of aneurysmal subarachnoid hemorrhage patients who were actively or very recently infected with SARS-CoV-2. Methods We reviewed subarachnoid hemorrhage cases of patients who were also SARS-CoV-2-positive at five high-volume cerebrovascular centers in the U.S from March 2020 to January 2021. Cases of aneurysmal subarachnoid hemorrhage were analyzed. Results A total of ten patients were identified, consisting of five women (50%) and five men (50%). Median age was 38.5 years. Four of the ten patients (40%) were asymptomatic with respect to SARS-CoV-2-related symptoms, three patients (30%) had mild-to-moderate symptoms, and three patients (30%) had severe COVID, with pneumonia and sepsis. Of the ten cases, four had dissecting pseudoaneurysms (40%), three in the posterior circulation and one in the anterior circulation. Among six saccular/blister aneurysms, four (67%) were ≤4 mm in largest diameter. Conclusions Our experience with aneurysmal subarachnoid hemorrhage in COVID-positive patients reveals a possibly distinct pattern compared to traditional aneurysmal subarachnoid hemorrhage, namely a high frequency of small aneurysms, dissecting pseudoaneurysms, and young patients.