Title:Prevalence of Coronavirus Disease 2019 in the Brain-dead Candidates for
Transplantation and Uncommon Manifestations of the Infection
Volume: 17
Issue: 4
Author(s): Mohsen Aliakbarian, Rozita Khodashahi*, Atefe Vakilian, Hamid Reza Naderi, Mandana Khodashahi , Ebrahim Khaleghi and Maliheh Dadgar Moghaddam
Affiliation:
- Department of Infectious Diseases and Tropical Medicine, Faculty of Medicine, Mashhad University
of Medical Sciences, Mashhad, Iran
Keywords:
Brain death, COVID-19, prevalence, transplantation, infection, manifestations.
Abstract: Aim: This study aimed to evaluate the prevalence of Coronavirus Disease 2019
(COVID-19) positive cases meeting clinical brain death criteria; moreover, it was attempted to assess
the uncommon manifestations of the infection in this study.
Materials and Methods: This retrospective observational study was conducted on all brain-dead patients
who were referred to the emergency department of hospitals in Mashhad, Iran, from February
to October 2020. The demographic characteristics, clinical information, and laboratory data
were collected and recorded in a researcher-made checklist.
Results: In general, 70 patients were entered in this study. The PCR test result was positive for
COVID-19 in 54% of the patients, and syncope was reported in 16.1% of the cases (n=10). Furthermore,
the majority of the patients (52.9%) showed Central Nervous System (CNS) hemorrhagic
manifestations. A comparison was made between the patients with positive and negative PCR test
result in terms of syncope; accordingly, there was a significant difference between them in this regard
(χ2=4.5; P=0.03). The CNS hemorrhagic manifestations were significantly higher in patients
with positive PCR compared to those with negative PCR (χ2=4.57, P=0.03). Moreover, the grand
glass opacity and pleural effusion were the most common findings of the chest computed tomography
in brain-dead patients with COVID-19.
Conclusion: Due to the high prevalence of COVID-19 among brain-dead patients, it seems that
syncope attack should be regarded as one of the possible symptoms of COVID-19. Moreover, syncope
as a result of COVID-19 may itself cause traumatic events. It is worth mentioning that CNS
hemorrhagic manifestations have been reported in more than half of the patients with brain death.
