Cerebrovascular Disease in Patients with COVID-19: A Review of the Literature and Case Series release_cbe4gdvxdngtxhxbk3ssvfg52i

by Sujan T. Reddy, Tanu Garg, Chintan Shah, Fábio A. Nascimento, Rajeel Imran, Peter Kan, Ritvij Bowry, Nicole Gonzales, Andrew Barreto, Abhay Kumar, John Volpi, Vivek Misra (+3 others)

Published in Case Reports in Neurology by S. Karger AG.

2020   Volume 12, Issue 2, p199-209

Abstract

COVID-19 has been associated with a hypercoagulable state causing cardiovascular and neurovascular complications. To further characterize cerebrovascular disease (CVD) in COVID-19, we review the current literature of published cases and additionally report the clinical presentation, laboratory and diagnostic testing results of 12 cases with COVID-19 infection and concurrent CVD from two academic medical centers in Houston, TX, USA, between March 1 and May 10, 2020. To date, there are 12 case studies reporting 47 cases of CVD in COVID-19. However, only 4 small case series have described the clinical and laboratory findings in patients with COVID-19 and concurrent stroke. Viral neurotropism, endothelial dysfunction, coagulopathy and inflammation are plausible proposed mechanisms of CVD in COVID-19 patients. In our case series of 12 patients, 10 patients had an ischemic stroke, of which 1 suffered hemorrhagic transformation and two had intracerebral hemorrhage. Etiology was determined to be embolic without a clear cause identified in 6 ischemic stroke patients, while the remaining had an identifiable source of stroke. The majority of the patients had elevated inflammatory markers such as D-dimer and interleukin-6. In patients with embolic stroke of unclear etiology, COVID-19 may have played a direct or indirect role in the processes that eventually led to the strokes while in the remaining cases, it is unclear if infection contributed partially or was an incidental finding.
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Type  article-journal
Stage   published
Date   2020-06-11
Language   en ?
DOI  10.1159/000508958
PubMed  32647526
PMC  PMC7325208
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