tetano
Editor, Senior Moderator
Front Cardiovasc Med
. 2023 Jan 10;9:1097229.
doi: 10.3389/fcvm.2022.1097229. eCollection 2022.
SARS-CoV-2 infection predicts larger infarct volume in patients with acute ischemic stroke
Manuela De Michele[SUP] 1 [/SUP], Svetlana Lorenzano[SUP] 2 [/SUP], Paola Piscopo[SUP] 3 [/SUP], Roberto Rivabene[SUP] 4 [/SUP], Alessio Crestini[SUP] 3 [/SUP], Antonio Chistolini[SUP] 4 [/SUP], Lucia Stefanini[SUP] 5 [/SUP], Fabio M Pulcinelli[SUP] 6 [/SUP], Irene Berto[SUP] 1 [/SUP], Roberta Campagna[SUP] 7 [/SUP], Paolo Amisano[SUP] 2 [/SUP], Marta Iacobucci[SUP] 8 [/SUP], Carlo Cirelli[SUP] 8 [/SUP], Anne Falcou[SUP] 1 [/SUP], Ettore Nicolini[SUP] 1 [/SUP], Oscar G Schiavo[SUP] 1 [/SUP], Danilo Toni[SUP] 2 [/SUP]
Affiliations
Abstract
Background and purpose: Acute ischemic stroke (AIS) is a fearful complication of Coronavirus Disease-2019 (COVID-19). Aims of this study were to compare clinical/radiological characteristics, endothelial and coagulation dysfunction between acute ischemic stroke (AIS) patients with and without COVID-19 and to investigate if and how the SARS-CoV-2 spike protein (SP) was implicated in triggering platelet activation.
Methods: We enrolled AIS patients with COVID-19 within 12 h from onset and compared them with an age- and sex-matched cohort of AIS controls without COVID-19. Neuroimaging studies were performed within 24 h. Blood samples were collected in a subset of 10 patients.
Results: Of 39 AIS patients, 22 had COVID-19 and 17 did not. Admission levels of Factor VIII and von Willebrand factor antigen were significantly higher in COVID-19 patients and positively correlated with the infarct volume. In multivariate linear regression analyses, COVID-19 was an independent predictor of infarct volume (B 20.318, Beta 0.576, 95%CI 6.077-34.559; p = 0.011). SP was found in serum of 2 of the 10 examined COVID-19 patients. Platelets from healthy donors showed a similar degree of procoagulant activation induced by COVID-19 and non-COVID-19 patients' sera. The anti-SP and anti-FcγRIIA blocking antibodies had no effect in modulating platelet activity in both groups.
Conclusions: SARS-CoV-2 infection seems to play a major role in endothelium activation and infarct volume extension during AIS.
Keywords: COVID-19; SARS-CoV-2; coagulation; endothelium activation; platelet activation; stroke; thrombosis.
. 2023 Jan 10;9:1097229.
doi: 10.3389/fcvm.2022.1097229. eCollection 2022.
SARS-CoV-2 infection predicts larger infarct volume in patients with acute ischemic stroke
Manuela De Michele[SUP] 1 [/SUP], Svetlana Lorenzano[SUP] 2 [/SUP], Paola Piscopo[SUP] 3 [/SUP], Roberto Rivabene[SUP] 4 [/SUP], Alessio Crestini[SUP] 3 [/SUP], Antonio Chistolini[SUP] 4 [/SUP], Lucia Stefanini[SUP] 5 [/SUP], Fabio M Pulcinelli[SUP] 6 [/SUP], Irene Berto[SUP] 1 [/SUP], Roberta Campagna[SUP] 7 [/SUP], Paolo Amisano[SUP] 2 [/SUP], Marta Iacobucci[SUP] 8 [/SUP], Carlo Cirelli[SUP] 8 [/SUP], Anne Falcou[SUP] 1 [/SUP], Ettore Nicolini[SUP] 1 [/SUP], Oscar G Schiavo[SUP] 1 [/SUP], Danilo Toni[SUP] 2 [/SUP]
Affiliations
- PMID: 36704480
- PMCID: PMC9871539
- DOI: 10.3389/fcvm.2022.1097229
Abstract
Background and purpose: Acute ischemic stroke (AIS) is a fearful complication of Coronavirus Disease-2019 (COVID-19). Aims of this study were to compare clinical/radiological characteristics, endothelial and coagulation dysfunction between acute ischemic stroke (AIS) patients with and without COVID-19 and to investigate if and how the SARS-CoV-2 spike protein (SP) was implicated in triggering platelet activation.
Methods: We enrolled AIS patients with COVID-19 within 12 h from onset and compared them with an age- and sex-matched cohort of AIS controls without COVID-19. Neuroimaging studies were performed within 24 h. Blood samples were collected in a subset of 10 patients.
Results: Of 39 AIS patients, 22 had COVID-19 and 17 did not. Admission levels of Factor VIII and von Willebrand factor antigen were significantly higher in COVID-19 patients and positively correlated with the infarct volume. In multivariate linear regression analyses, COVID-19 was an independent predictor of infarct volume (B 20.318, Beta 0.576, 95%CI 6.077-34.559; p = 0.011). SP was found in serum of 2 of the 10 examined COVID-19 patients. Platelets from healthy donors showed a similar degree of procoagulant activation induced by COVID-19 and non-COVID-19 patients' sera. The anti-SP and anti-FcγRIIA blocking antibodies had no effect in modulating platelet activity in both groups.
Conclusions: SARS-CoV-2 infection seems to play a major role in endothelium activation and infarct volume extension during AIS.
Keywords: COVID-19; SARS-CoV-2; coagulation; endothelium activation; platelet activation; stroke; thrombosis.