Trends Neurosci . The emerging association between COVID-19 and acute stroke

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Trends Neurosci


. 2021 Apr 8;S0166-2236(21)00071-0.
doi: 10.1016/j.tins.2021.03.005. Online ahead of print.
The emerging association between COVID-19 and acute stroke


Laura K Stein ¹ , Naomi A Mayman ² , Mandip S Dhamoon ¹ , Johanna T Fifi ³



Affiliations

• PMID: 33879319
• DOI: 10.1016/j.tins.2021.03.005

Abstract

Prior to COVID-19, only two human-tropic coronaviruses resulted in epidemics and cerebrovascular disease was rarely reported. Evidence now suggests that 1-6% of hospitalized COVID-19 patients develop stroke. According to some reports, stroke risk is more than sevenfold greater in patients with COVID-19 than influenza. Concerningly, outcomes of COVID-19-related stroke are often worse than in stroke patients without COVID-19 from the same cohorts. In this review, we highlight the emerging association between COVID-19 and stroke and discuss putative pathogenetic mechanisms. Etiology of stroke in COVID-19 patients is likely multifactorial, related to coagulopathy, inflammation, platelet activation, and alterations to the vascular endothelium. Significant work remains to be done to better understand the pathogenesis of COVID-19-related stroke and for designing optimal primary and secondary prevention strategies.

Keywords: SARS-COV-2; cerebrovascular disease; coronavirus; pandemic; thrombectomy; thrombolysis; thrombosis.