Cerebrovascular Disease in Patients with COVID-19: A Review of the Literature and Case Series
| Autor: | Tanu Garg, Sean I Savitz, David Chiu, Peter Kan, Rajan R Gadhia, Chintan Shah, Sujan T Reddy, Nicole R. Gonzales, Rajeel Imran, Vivek Misra, Abhay Kumar, Andrew D Barreto, Ritvij Bowry, John Volpi, Fábio A. Nascimento |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19) lcsh:RC346-429 APLS 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Coagulopathy In patient 030212 general & internal medicine cardiovascular diseases Endothelial dysfunction Cerebrovascular disease Stroke lcsh:Neurology. Diseases of the nervous system Intracerebral hemorrhage business.industry SARS-CoV-2 COVID-19 medicine.disease Neurovascular bundle Coronavirus Etiology Neurology (clinical) business 030217 neurology & neurosurgery Single Case − General Neurology |
| Zdroj: | Case Reports in Neurology Case Reports in Neurology, Vol 12, Iss 2, Pp 199-209 (2020) |
| ISSN: | 1662-680X |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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