COVID‐19 and Ischemic Stroke: Clinical and Neuroimaging Findings
Autor: | Mònica Cos, Ana Nuñez, Pablo Naval-Baudin, Pere Cardona, Maria Montserrat Fernández Viñas, Albert Pons-Escoda, Nahum Calvo, Isabel Rodriguez Caamaño, Cecilia Rubio-Maicas, Carles Majós |
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Rok vydání: | 2020 |
Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Clinical Neurology Infarction Neuroimaging 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale Internal medicine Occlusion medicine Humans Radiology Nuclear Medicine and imaging Pandemics Stroke Aged Ischemic Stroke Retrospective Studies Aged 80 and over SARS-CoV-2 business.industry Microangiopathy COVID-19 Thrombolysis Middle Aged medicine.disease Arterial occlusion Cross-Sectional Studies Respiratory failure Radiology Nuclear Medicine and imaging Cardiology Female Neurology (clinical) Tomography X-Ray Computed business 030217 neurology & neurosurgery |
Zdroj: | Journal of Neuroimaging |
ISSN: | 1552-6569 1051-2284 |
Popis: | Background and purpose SARS-CoV-2 causes multiorgan disease due to altered coagulability and microangiopathy. Patients may have an increased risk of cerebrovascular accidents (CVA). Our objective was to analyze clinical and neuroimaging characteristics of patients with ischemic CVA during the pandemic peak in our region, in order to identify atypical presentations. Methods We performed a cross-sectional analysis of patients admitted under code-stroke protocol to our center with a final diagnosis of ischemic brain infarction. We analyzed the main imaging and demographic characteristics and reviewed neuroimaging for atypical presentations. Results One-hundred patients with confirmed ischemic CVA were included. Nineteen had positive polymerase chain reaction testing for SARS-CoV-2 on admission. These patients had a lower prevalence of proximal arterial occlusion on imaging, higher in-hospital mortality, and worse baseline disability. No differences were identified in affected vascular territory, volume of infarction, initial CT stroke score, prevalence of hemorrhagic transformation, gender, age, cardiovascular risk factors, time to admission, symptom severity on entry, or decision to treat with thrombolysis or mechanical thrombectomy. Prevalence of COVID-19 in our code-stroke sample was higher than that for our province during this time period. Conclusion The COVID-19 group had more in-hospital mortality, less proximal arterial occlusion on CT or MR angiography, and lower baseline modified Rankin Scale score. We suggest a possibly higher proportion of microangiopathic involvement or undetected distal large-vessel occlusion in the COVID-19 stroke group. Excess mortality was explained by severe respiratory failure. Otherwise, stroke patients with COVID-19 did not differ demographically or clinically from those without the illness. |
Databáze: | OpenAIRE |
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