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  1. Article: COVID-19 and Cerebral Hemorrhage: Proposed Mechanisms.

    Md Noh, Mohamad Syafeeq Faeez

    Journal of neuroradiology = Journal de neuroradiologie

    2020  Volume 48, Issue 2, Page(s) 125–126

    MeSH term(s) COVID-19/complications ; Cerebral Hemorrhage/virology ; Humans ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-01
    Publishing country France
    Document type Letter
    ZDB-ID 131763-5
    ISSN 1773-0406 ; 0150-9861
    ISSN (online) 1773-0406
    ISSN 0150-9861
    DOI 10.1016/j.neurad.2020.05.007
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    Zs.A 1062: Show issues Location:
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  3. Article ; Online: Vitamin D and its Possible Relationship to Neuroprotection in COVID-19: Evidence in the Literature.

    Quintero-Fabián, Saray / Bandala, Cindy / Pichardo-Macías, Luz Adriana / Contreras-García, Itzel Jatziri / Gómez-Manzo, Saúl / Hernández-Ochoa, Beatriz / Martínez-Orozco, José Arturo / Ignacio-Mejía, Iván / Cárdenas-Rodríguez, Noemí

    Current topics in medicinal chemistry

    2022  Volume 22, Issue 16, Page(s) 1346–1368

    Abstract: ... and survival of patients infected with COVID-19 probably because of its anti-inflammatory, antiviral ... homeostasis between other mechanisms. It has been shown that COVID-19 infection induces CNS complications ... of vitamin D, and its metabolites, as a protector against the neurological manifestations of COVID-19 was ...

    Abstract Vitamin D is a hormone involved in the regulation of important biological processes such as signal transduction, immune response, metabolic regulation and also in the nervous and vascular systems. To date, coronavirus disease 2019 (COVID-19) infection does not have a specific treatment. However, various drugs have been proposed, including those that attenuate the intense inflammatory response, and recently, the use of vitamin D, in clinical trials, as part of the treatment of COVID-19 has provided promising results. It has been observed in some clinical studies that the use of cholecalciferol (vitamin D3) and its two metabolites the circulating form, calcidiol or calcifediol (25-hydroxycalciferol, 25-(OH)-D), and the active form, calcitriol (1,25-(OH)2-D), in different doses, improve the clinical manifestations, prognosis, and survival of patients infected with COVID-19 probably because of its anti-inflammatory, antiviral and lung-protective action. In relation to the central nervous system (CNS) it has been shown, in clinical studies, that vitamin D is beneficial in some neurological and psychiatric conditions because of its anti-inflammatory and antioxidant properties, modulation of neurotransmitters actions, and regulation of calcium homeostasis between other mechanisms. It has been shown that COVID-19 infection induces CNS complications such as headache, anosmia, ageusia, neuropathy, encephalitis, stroke, thrombosis, cerebral hemorrhages, cytotoxic lesions, and psychiatric conditions and it has been proposed that the use of dietary supplements, as vitamin and minerals, can be adjuvants in this disease. In this review, the evidence of the possible role of vitamin D, and its metabolites, as a protector against the neurological manifestations of COVID-19 was summarized.
    MeSH term(s) COVID-19/drug therapy ; Calcifediol/therapeutic use ; Cholecalciferol ; Humans ; Neuroprotection ; Vitamin D/metabolism ; Vitamin D/pharmacology ; Vitamin D/therapeutic use ; Vitamins/pharmacology ; Vitamins/therapeutic use
    Chemical Substances Vitamins ; Vitamin D (1406-16-2) ; Cholecalciferol (1C6V77QF41) ; Calcifediol (P6YZ13C99Q)
    Language English
    Publishing date 2022-04-19
    Publishing country United Arab Emirates
    Document type Journal Article ; Review
    ZDB-ID 2064823-6
    ISSN 1873-4294 ; 1568-0266
    ISSN (online) 1873-4294
    ISSN 1568-0266
    DOI 10.2174/1568026622666220401140737
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    Zs.A 5572: Show issues Location:
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  4. Article ; Online: Cerebral microhaemorrhage in COVID-19

    Dixon, L

    A critical illness related phenomenon?

    2020  

    Abstract: ... through assessing the pattern of microhaemorrhage and clinical characteristics of patients with COVID-19 and ... was performed identifying all patients with COVID-19 complicated by cerebral microhaemorrhage on MRI ... of cerebral microhaemorrhage which is similar to the pattern reported in patients with non-COVID-19 related ...

    Abstract BackgroundCerebral microhaemorrhages are increasingly being recognised as a complication of COVID-19. This observational retrospective study aims to further investigate the potential pathophysiology through assessing the pattern of microhaemorrhage and clinical characteristics of patients with COVID-19 and microhaemorrhage. By comparing to similar patterns of microhaemorrhage in other non-COVID-19 disease this study aims to propose possible common pathogenic mechanisms. MethodsA retrospective observational case series was performed identifying all patients with COVID-19 complicated by cerebral microhaemorrhage on MRI. The distribution and number of microhaemorrhages were recorded using the microbleed anatomical scale (MARS) and patients baseline characteristics and salient test results were also recorded. ResultsCerebral microhaemorrhages were noted to have a predilection for the corpus callosum, the juxtacortical white matter and brainstem. All patients had a preceding period of critical illness with respiratory failure and severe hypoxia necessitating intubation and mechanical ventilation. DiscussionThis study demonstrates a pattern of cerebral microhaemorrhage which is similar to the pattern reported in patients with non-COVID-19 related critical illness and other causes of severe hypoxia. This raises questions regarding whether microhaemorrhage occurs from endothelial dysfunction due the direct effect of SARS-CoV-2 infection or from the secondary effects of critical illness and hypoxia.
    Keywords covid19
    Publishing date 2020-10-24
    Publisher BMJ Publishing Ltd
    Publishing country uk
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: COVID-19 and Cerebral Hemorrhage

    Md Noh, Mohamad Syafeeq Faeez

    Journal of Neuroradiology ; ISSN 0150-9861

    Proposed Mechanisms

    2020  

    Keywords Radiological and Ultrasound Technology ; Radiology Nuclear Medicine and imaging ; Clinical Neurology ; covid19
    Language English
    Publisher Elsevier BV
    Publishing country us
    Document type Article ; Online
    DOI 10.1016/j.neurad.2020.05.007
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Cerebral microhaemorrhage in COVID-19: a critical illness related phenomenon?

    Dixon, Luke / McNamara, Cillian / Gaur, Pritika / Mallon, Dermot / Coughlan, Christopher / Tona, Francesca / Jan, Wajanat / Wilson, Mark / Jones, Brynmor

    Stroke and vascular neurology

    2020  Volume 5, Issue 4, Page(s) 315–322

    Abstract: ... with COVID-19 and microhaemorrhage. By comparing with similar patterns of microhaemorrhage in other non-COVID ... in patients with non-COVID-19 related critical illness and other causes of severe hypoxia. This raises ... 19 disease, this study aims to propose possible common pathogenic mechanisms.: Methods ...

    Abstract Background: Cerebral microhaemorrhages are increasingly being recognised as a complication of COVID-19. This observational retrospective study aims to further investigate the potential pathophysiology through assessing the pattern of microhaemorrhage and clinical characteristics of patients with COVID-19 and microhaemorrhage. By comparing with similar patterns of microhaemorrhage in other non-COVID-19 disease, this study aims to propose possible common pathogenic mechanisms.
    Methods: A retrospective observational case series was performed identifying all patients with COVID-19 complicated by cerebral microhaemorrhage on MRI. The distribution and number of microhaemorrhages were recorded using the microbleed anatomical scale, and patients' baseline characteristics and salient test results were also recorded.
    Results: Cerebral microhaemorrhages were noted to have a predilection for the corpus callosum, the juxtacortical white matter and brainstem. All patients had a preceding period of critical illness with respiratory failure and severe hypoxia necessitating intubation and mechanical ventilation.
    Discussion: This study demonstrates a pattern of cerebral microhaemorrhage that is similar to the pattern reported in patients with non-COVID-19 related critical illness and other causes of severe hypoxia. This raises questions regarding whether microhaemorrhage occurs from endothelial dysfunction due the direct effect of SARS-CoV-2 infection or from the secondary effects of critical illness and hypoxia.
    MeSH term(s) Aged ; Brain Stem/diagnostic imaging ; COVID-19/complications ; COVID-19/diagnostic imaging ; Cerebral Hemorrhage/diagnostic imaging ; Cerebral Hemorrhage/etiology ; Corpus Callosum/diagnostic imaging ; Critical Illness ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Respiration, Artificial ; Respiratory Insufficiency/etiology ; Retrospective Studies ; Treatment Outcome ; White Matter/diagnostic imaging
    Keywords covid19
    Language English
    Publishing date 2020-11-18
    Publishing country England
    Document type Journal Article ; Observational Study ; Research Support, Non-U.S. Gov't
    ISSN 2059-8696
    ISSN (online) 2059-8696
    DOI 10.1136/svn-2020-000652
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  7. Article ; Online: Potential mechanisms of hemorrhagic stroke in elderly COVID-19 patients.

    Wang, Haili / Tang, Xiaojia / Fan, Hongyang / Luo, Yuhan / Song, Yuxia / Xu, Yao / Chen, Yingzhu

    Aging

    2020  Volume 12, Issue 11, Page(s) 10022–10034

    Abstract: ... to hemorrhagic stroke in the elderly and proposes possible mechanisms. Reports show that the most affected ... comorbidities and critically influence the pathogenesis of hemorrhagic stroke by elevating blood pressure and ... disease 2019, a new human infectious disease. While fever, cough, and respiratory distress are typical ...

    Abstract The novel severe acute respiratory syndrome coronavirus 2 is the causative agent of coronavirus disease 2019, a new human infectious disease. While fever, cough, and respiratory distress are typical first symptoms, a fraction of those affected present instead with neurological symptoms suggestive of central nervous system compromise. This review summarizes the potential contribution of coronavirus disease 2019 to hemorrhagic stroke in the elderly and proposes possible mechanisms. Reports show that the most affected patients have underlying chronic diseases such as hypertension and diabetes, which are two key risk factors for hemorrhagic stroke. Angiotensin-converting enzyme 2 is the main host cell surface receptor interacting with the severe acute respiratory syndrome coronavirus 2 spike glycoprotein to allow viral entry and infection. We speculate that ensuing downregulation of angiotensin-converting enzyme 2 expression may compound the risk conferred by pre-existing comorbidities and critically influence the pathogenesis of hemorrhagic stroke by elevating blood pressure and impairing cerebrovascular endothelial function. Additionally, both age- and/or disease-related immune dysfunction and enhanced catecholamine release secondary to anxiety and stress may also aggravate central nervous system symptoms of severe acute respiratory syndrome coronavirus 2 infection. Thus, assessment of systemic inflammatory biomarkers and tight control of hemodynamic parameters upon admission are crucial to minimize mortality and morbidity in coronavirus disease 2019 patients with central nervous system symptoms suggestive of incipient stroke.
    MeSH term(s) Aged ; Animals ; COVID-19 ; Cerebral Hemorrhage/virology ; Coronavirus Infections/complications ; Coronavirus Infections/immunology ; Coronavirus Infections/virology ; Humans ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/immunology ; Pneumonia, Viral/virology ; Risk Factors ; Stroke/virology
    Keywords covid19
    Language English
    Publishing date 2020-06-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ISSN 1945-4589
    ISSN (online) 1945-4589
    DOI 10.18632/aging.103335
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  8. Article ; Online: COVID-19 Severity and Stroke: Correlation of Imaging and Laboratory Markers.

    Katz, J M / Libman, R B / Wang, J J / Filippi, C G / Sanelli, P / Zlochower, A / Gribko, M / Pacia, S V / Kuzniecky, R I / Najjar, S / Azhar, S

    AJNR. American journal of neuroradiology

    2020  Volume 42, Issue 2, Page(s) 257–261

    Abstract: ... coagulopathy, and tissue-damage biomarkers, supporting proposed pathogenic mechanisms of hyperinflammation ... Background and purpose: Coronavirus disease 2019 (COVID-19) appears to be an independent ... for COVID-19 with out-of-hospital stroke onset and milder or no COVID-19 symptoms.: Materials and methods ...

    Abstract Background and purpose: Coronavirus disease 2019 (COVID-19) appears to be an independent risk factor for stroke. We hypothesize that patients who develop stroke while hospitalized for severe COVID-19 will have higher inflammatory markers and distinct stroke imaging patterns compared with patients positive for COVID-19 with out-of-hospital stroke onset and milder or no COVID-19 symptoms.
    Materials and methods: This is a retrospective case series of patients positive for COVID-19 on polymerase chain reaction testing with imaging-confirmed stroke treated within a large health care network in New York City and Long Island between March 14 and April 26, 2020. Clinical and laboratory data collected retrospectively included complete blood counts and creatinine, alanine aminotransferase, lactate dehydrogenase, C-reactive protein, ferritin, and D-dimer levels. All CT and MR imaging studies were independently reviewed by 2 neuroradiologists who recorded stroke subtype and patterns of infarction and intracranial hemorrhage.
    Results: Compared with patients with COVID-19 with outside-of-hospital stroke onset and milder or no COVID-19 symptoms (
    Conclusions: Patients with stroke hospitalized with severe COVID-19 are characterized by higher inflammatory, coagulopathy, and tissue-damage biomarkers, supporting proposed pathogenic mechanisms of hyperinflammation activating a prothrombotic state. Cautious balancing of thrombosis and the risk of hemorrhagic transformation is warranted when considering anticoagulation.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Biomarkers ; Blood Coagulation Disorders/etiology ; COVID-19/complications ; COVID-19/diagnostic imaging ; Cerebral Infarction/complications ; Cerebral Infarction/diagnostic imaging ; Female ; Hospitalization ; Humans ; Liver Diseases/etiology ; Lymphopenia/blood ; Lymphopenia/etiology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Polymerase Chain Reaction ; Retrospective Studies ; Stroke/complications ; Stroke/diagnostic imaging ; Thrombosis/complications ; Tomography, X-Ray Computed
    Chemical Substances Biomarkers
    Keywords covid19
    Language English
    Publishing date 2020-10-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603808-6
    ISSN 1936-959X ; 0195-6108
    ISSN (online) 1936-959X
    ISSN 0195-6108
    DOI 10.3174/ajnr.A6920
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  9. Article: Simultaneous Occurrence of Cerebral Venous Sinus Thrombosis and Immune Thrombocytopenic Purpura in a Patient with a History of COVID-19 Infection.

    Bahadorizadeh, Leyla / Emamikhah, Maziar / Pour Mohammad, Arash / Gholizadeh Mesgarha, Milad

    Neurology and therapy

    2021  Volume 11, Issue 1, Page(s) 491–497

    Abstract: ... for this circumstance: either COVID-19 infection caused ITP and then ITP gave rise to CVST, or COVID-19 complications ... and hemorrhagic venous infarction. In addition, laboratory data revealed thrombocytopenia ... Since the emergence of the coronavirus disease 2019 (COVID-19) pandemic, multiple but rare ...

    Abstract Since the emergence of the coronavirus disease 2019 (COVID-19) pandemic, multiple but rare complications of this infection have been described, comprising cerebral venous sinus thrombosis (CVST) and immune thrombocytopenic purpura (ITP). Although these two complications have been reported as separate entities, to the best of our knowledge, their concurrent presentation has not been reported. In this case report, we present a middle-aged man with a history of COVID-19 infection who developed a sudden-onset severe occipital headache followed by right-sided blindness (right homonymous hemianopia). Upon his diagnostic workup, brain computed tomography scan with and without contrast was indicative of thrombosis of the left transverse venous sinus and hemorrhagic venous infarction. In addition, laboratory data revealed thrombocytopenia, which upon investigation confirmed a diagnosis of ITP. We postulate three pathophysiological mechanisms for this circumstance: either COVID-19 infection caused ITP and then ITP gave rise to CVST, or COVID-19 complications themselves resulted in ITP and CVST independently and simultaneously, or another plausible mechanism is immune-mediated thrombocytopenia caused by the anti-platelet 4-factor antibody, which is the proposed mechanism for CVST after the COVID-19 vaccine.
    Language English
    Publishing date 2021-10-29
    Publishing country New Zealand
    Document type Journal Article
    ISSN 2193-8253
    ISSN 2193-8253
    DOI 10.1007/s40120-021-00294-9
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