tetano
Editor, Senior Moderator
Cureus
. 2020 Aug 31;12(8):e10157.
doi: 10.7759/cureus.10157.
Acute Ischemic and Hemorrhagic Stroke in COVID-19: Mounting Evidence
Kartikeya Rajdev[SUP] 1 [/SUP], Shubham Lahan[SUP] 2 [/SUP], Kate Klein[SUP] 3 [/SUP], Craig A Piquette[SUP] 1 [/SUP], Meilinh Thi[SUP] 1 [/SUP]
Affiliations
Abstract
The novel coronavirus disease of 2019 (COVID-19) is caused by the binding of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to angiotensin-converting enzyme 2 (ACE2) receptors present on various locations such as the pulmonary alveolar epithelium and vascular endothelium. In COVID-19 patients, the interaction of SARS-CoV-2 with these receptors in the cerebral blood vessels has been attributed to stroke. Although the incidence of acute ischemic stroke is relatively low, ranging from 1% to 6%, the mortality associated with it is substantially high, reaching as high as 38%. This case series describes three distinct yet similar scenarios of COVID-19 positive patients with several underlying comorbidities, wherein two of the patients presented to our hospital with sudden onset right-sided weakness, later diagnosed with ischemic stroke, and one patient who developed an acute intracerebral hemorrhage during his hospital stay. The patients were diagnosed with acute stroke as a complication of COVID-19 infection. We also provide an insight into the possible mechanisms responsible for the life-threatening complication. Physicians should have a low threshold for suspecting stroke in COVID-19 patients, and close observation should be kept on such patients particularly those with clinical evidence of traditional risk factors.
Keywords: co-morbidity; complication; covid-19; intracerebral hemorrhage; mortality; stroke.
. 2020 Aug 31;12(8):e10157.
doi: 10.7759/cureus.10157.
Acute Ischemic and Hemorrhagic Stroke in COVID-19: Mounting Evidence
Kartikeya Rajdev[SUP] 1 [/SUP], Shubham Lahan[SUP] 2 [/SUP], Kate Klein[SUP] 3 [/SUP], Craig A Piquette[SUP] 1 [/SUP], Meilinh Thi[SUP] 1 [/SUP]
Affiliations
- PMID: 33014653
- PMCID: PMC7526955
- DOI: 10.7759/cureus.10157
Abstract
The novel coronavirus disease of 2019 (COVID-19) is caused by the binding of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) to angiotensin-converting enzyme 2 (ACE2) receptors present on various locations such as the pulmonary alveolar epithelium and vascular endothelium. In COVID-19 patients, the interaction of SARS-CoV-2 with these receptors in the cerebral blood vessels has been attributed to stroke. Although the incidence of acute ischemic stroke is relatively low, ranging from 1% to 6%, the mortality associated with it is substantially high, reaching as high as 38%. This case series describes three distinct yet similar scenarios of COVID-19 positive patients with several underlying comorbidities, wherein two of the patients presented to our hospital with sudden onset right-sided weakness, later diagnosed with ischemic stroke, and one patient who developed an acute intracerebral hemorrhage during his hospital stay. The patients were diagnosed with acute stroke as a complication of COVID-19 infection. We also provide an insight into the possible mechanisms responsible for the life-threatening complication. Physicians should have a low threshold for suspecting stroke in COVID-19 patients, and close observation should be kept on such patients particularly those with clinical evidence of traditional risk factors.
Keywords: co-morbidity; complication; covid-19; intracerebral hemorrhage; mortality; stroke.