COVID-19 Presenting As Stroke

Overview

Journal Brain Behav Immun

Publisher Elsevier

Specialties Allergy & Immunology
Neurology
Psychiatry

Date 2020 May 4

PMID 32360439

Citations 315

Authors

Akshay Avula

Krishna Nalleballe

Naureen Narula

Steven Sapozhnikov

Vasuki Dandu

Sudhamshi Toom

Allison Glaser

Dany Elsayegh

Affiliations

Soon will be listed here.

Abstract

Objective: Acute stroke remains a medical emergency even during the COVID-19 pandemic. Most patients with COVID-19 infection present with constitutional and respiratory symptoms; while others present with atypical gastrointestinal, cardiovascular, or neurological manifestations. Here we present a series of four patients with COVID-19 that presented with acute stroke.

Methods: We searched the hospital databases for patients that presented with acute stroke and concomitant features of suspected COVID-19 infection. All patients who had radiographic evidence of stroke and PCR-confirmed COVID-19 infection were included in the study. Patients admitted to the hospital with PCR- confirmed COVID-19 disease whose hospital course was complicated with acute stroke while inpatient were excluded from the study. Retrospective patient data were obtained from electronic medical records. Informed consent was obtained.

Results: We identified four patients who presented with radiographic confirmation of acute stroke and PCR-confirmed SARS-CoV-2 infection. We elucidate the clinical characteristics, imaging findings, and the clinical course.

Conclusions: Timely assessment and hyperacute treatment is the key to minimize mortality and morbidity of patients with acute stroke. Stroke teams should be wary of the fact that COVID-19 patients can present with cerebrovascular accidents and should dawn appropriate personal protective equipment in every suspected patient. Further studies are urgently needed to improve current understandings of neurological pathology in the setting of COVID-19 infection.

Citing Articles

Association between SARS-CoV-2 and stroke: perspectives from a metaumbrella-review.

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TLR2/NF-κB signaling in macrophage/microglia mediated COVID-pain induced by SARS-CoV-2 envelope protein.

Cui H, Sun F, Yu N, Cao Y, Wang X, Zhang D iScience. 2024; 27(10):111027.

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Prediction of Stroke After the COVID-19 Infection.

Babaee M, Atashgar K, Harandi A, Yousefi A Basic Clin Neurosci. 2024; 15(1):89-100.

PMID: 39291093 PMC: 11403102. DOI: 10.32598/bcn.2022.3608.1.

Stroke and COVID-19: An Umbrella Review.

Shahsavarinia K, Hajipoor Kashgsaray N, Ghojazadeh M, Falaki Z, Soleimanpour M, Soleimanpour H Arch Acad Emerg Med. 2024; 12(1):e65.

PMID: 39290764 PMC: 11407545. DOI: 10.22037/aaem.v12i1.2385.

Role of Imaging in Diagnosis and Management of COVID-19: Evidence-Based Approaches.

Pezzutti D, Makary M Adv Exp Med Biol. 2024; 1457:237-246.

PMID: 39283430 DOI: 10.1007/978-3-031-61939-7_13.

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