학술논문
Ischemic Stroke in Patients with COVID-19 Disease: A Report of 10 Cases from Iran
Document Type
Report
Author
Source
Cerebrovascular Diseases. April 1, 2021, Vol. 50 Issue 2, p239, 6 p.
Subject
Language
English
ISSN
1015-9770
Abstract
Author(s): Sanaz Ahmadi Karvigh [a]; Fahimeh Vahabizad (corresponding author) [a]; Gelareh Banihashemi [a]; Mohammad Ali Sahraian [a,b]; Mohammad Reza Gheini [a]; Mahdieh Eslami [a]; Hoora Marhamati [a]; Maryam Sadat Mirhadi [...]
Ischemic stroke seems to be one of the most serious neurologic complications in patients with COVID-19 infection. Herein, we report a series of 10 ischemic stroke patients with concomitant COVID-19 disease. Out of 10, 8 had large infarcts (3 massive middle cerebral artery, 2 basilar artery, 2 posterior cerebral artery, and 1 internal carotid artery infarct territory). Two had cardiogenic embolic stroke due to atrial fibrillation. Almost half of our patients did not have a vascular risk factor. Nine did not have fever and were diagnosed with COVID-19 upon admission for stroke. Stroke occurred in the first week of respiratory symptoms with moderate pulmonary involvement. Most Patients did not have hypoxia and did not establish respiratory failure or acute respiratory distress syndrome. The blood pressures were low and hemorrhagic transformation did not occur even after antiplatelet or anticoagulant therapy. Patients had markedly increased levels of lactate dehydrogenase, C-reactive protein, and D-dimer. Three patients died. It seems that ischemic strokes in COVID-19 patients tend to occur as large infarct and can be seen in patients with mild to moderate pulmonary involvement. Keywords: Coronavirus, COVID-19, Neurological manifestations, Case series study, Cerebrovascular diseases, Ischemic stroke
Ischemic stroke seems to be one of the most serious neurologic complications in patients with COVID-19 infection. Herein, we report a series of 10 ischemic stroke patients with concomitant COVID-19 disease. Out of 10, 8 had large infarcts (3 massive middle cerebral artery, 2 basilar artery, 2 posterior cerebral artery, and 1 internal carotid artery infarct territory). Two had cardiogenic embolic stroke due to atrial fibrillation. Almost half of our patients did not have a vascular risk factor. Nine did not have fever and were diagnosed with COVID-19 upon admission for stroke. Stroke occurred in the first week of respiratory symptoms with moderate pulmonary involvement. Most Patients did not have hypoxia and did not establish respiratory failure or acute respiratory distress syndrome. The blood pressures were low and hemorrhagic transformation did not occur even after antiplatelet or anticoagulant therapy. Patients had markedly increased levels of lactate dehydrogenase, C-reactive protein, and D-dimer. Three patients died. It seems that ischemic strokes in COVID-19 patients tend to occur as large infarct and can be seen in patients with mild to moderate pulmonary involvement. Keywords: Coronavirus, COVID-19, Neurological manifestations, Case series study, Cerebrovascular diseases, Ischemic stroke