Article ; Online: COVID-19 and Stroke: Casual or Causal Role?
Cerebrovascular diseases (Basel, Switzerland)
2020 Volume 49, Issue 3, Page(s) 341–344
Abstract: ... a surface protein also expressed by endothelial cells. This case suggests that COVID-19 can favor strokes and ... a case of stroke in a 62-year-old COVID-19-positive patient, with multiple vascular risk factors ... to rehabilitation.: Discussion: Until now, few cases of stroke in COVID-19 have been described, mainly in severe ...
| Abstract | Background: The COVID-19 outbreak is currently the major public health concern worldwide. This infection, caused by the novel coronavirus Sars Cov2, primarily affects respiratory system, but there is increasing evidence of neurologic involvement and cerebrovascular accidents. Case report: We present a case of stroke in a 62-year-old COVID-19-positive patient, with multiple vascular risk factors. The patient arrived 1 h after onset of symptoms, was treated with recombinant tissue plasminogen activator (rtPA) with improvement of neurologic deficits, and later developed right foot arterial ischemia (recanalized by balloon catheter angioplasty) and left arm superficial venous thrombosis. A control computed tomography (CT) scan 7 days after onset showed hemorrhagic transformation of ischemic lesion without mass effect. However, respiratory and neurologic conditions improved so that the patient was discharged to rehabilitation. Discussion: Until now, few cases of stroke in COVID-19 have been described, mainly in severe forms. This patient had ischemic injuries in different sites as well as venous thrombosis; hence, we speculate that Sars Cov2 could have a direct role in promoting vascular accidents since its receptor ACE2 is a surface protein also expressed by endothelial cells. This case suggests that COVID-19 can favor strokes and in general vascular complications, even in milder cases, and the presence of preexisting risk factors could play a determinant role. |
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| MeSH term(s) | COVID-19 ; Causality ; Cerebrovascular Disorders/etiology ; Coronavirus Infections/complications ; Coronavirus Infections/diagnostic imaging ; Humans ; Lung/diagnostic imaging ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnostic imaging ; Risk Factors ; Stroke/diagnostic imaging ; Stroke/drug therapy ; Stroke/etiology ; Thrombolytic Therapy ; Tissue Plasminogen Activator/therapeutic use ; Tomography, X-Ray Computed |
| Chemical Substances | Tissue Plasminogen Activator (EC 3.4.21.68) |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-07-07 |
| Publishing country | Switzerland |
| Document type | Case Reports |
| ZDB-ID | 1069462-6 |
| ISSN | 1421-9786 ; 1015-9770 |
| ISSN (online) | 1421-9786 |
| ISSN | 1015-9770 |
| DOI | 10.1159/000509453 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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