Cerebral Infarction in an Elderly Patient with Coronavirus Disease

Alay, Handan; Can, Fatma Kesmez; Gozgec, Elif

doi:10.1590/0037-8682-0307-2020

Cited by 5 publications

(2 citation statements)

References 2 publications

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“…There were 10 retrospective cohort studies, 6 case series, and 10 case reports with patients of interest. 3 , 12 , 13 , 16 , 17 , 19 , 24 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 – 39 …”

Section: Resultsmentioning

confidence: 99%

Clinical Characteristics of Stroke with COVID-19: A Systematic Review and Meta-Analysis

Yamakawa

Kuno

Mikami

et al. 2020

Journal of Stroke and Cerebrovascular Diseases

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Background The coronavirus disease 2019 (COVID-19) potentially increases the risk of thromboembolism and stroke. Numerous case reports and retrospective cohort studies have been published with mixed characteristics of COVID-19 patients with stroke regarding age, comorbidities, treatment, and outcome. We aimed to depict the frequency and clinical characteristics of COVID-19 patients with stroke. Methods PubMed and EMBASE were searched on June 10, 2020, to investigate COVID-19 and stroke through retrospective cross-sectional studies, case series/reports according to PRISMA guidelines. Study-specific estimates were combined using one-group meta-analysis in a random-effects model. Results 10 retrospective cohort studies and 16 case series/reports were identified including 183 patients with COVID-19 and stroke. The frequency of detected stroke in hospitalized COVID-19 patients was 1.1% ([95% confidential interval (CI)]: [0.6-1.6], I 2 = 62.9%). Mean age was 66.6 ([58.4-74.9], I 2 = 95.1%), 65.6% was male (61/93 patients). Mean days from symptom onset of COVID-19 to stroke was 8.0 ([4.1-11.9], p < 0.001, I 2 = 93.1%). D-dimer was 3.3 μg/mL ([1.7-4.9], I 2 = 86.3%), and cryptogenic stroke was most common as etiology at 50.7% ([31.0-70.4] I 2 = 64.1%, 39/71patients). Case fatality rate was 44.2% ([27.9-60.5], I 2 = 66.7%, 40/100 patients). Conclusions This systematic review assessed the frequency and clinical characteristics of stroke in COVID-19 patients. The frequency of detected stroke in hospitalized COVID-19 patients was 1.1% and associated with older age and stroke risk factors. Frequent cryptogenic stroke and elevated d-dimer level support increased risk of thromboembolism in COVID-19 associated with high mortality. Further study is needed to elucidate the pathophysiology and prognosis of stroke in COVID-19 to achieve most effective care for this population.

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Section: Resultsmentioning

confidence: 99%

Clinical Characteristics of Stroke with COVID-19: A Systematic Review and Meta-Analysis

Yamakawa

Kuno

Mikami

et al. 2020

Journal of Stroke and Cerebrovascular Diseases

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“…Anosmia has been widely reported as an early onset symptom (5). Neurological diseases such as cerebral hemorrhage and cerebral infarction have also been reported in addition to nonspecific symptoms such as headache, lethargy, and gait disturbance (6,7).…”

Section: Introductionmentioning

confidence: 99%

Can persistent hiccups be a progression marker in COVID-19?

Alay¹,

Doğan²,

Özkurt³

et al. 2021

Journal of Health Sciences and Medicine

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Hiccup is a reflex action that may rarely be intractable. A 55-year-old man diagnosed with COVID-19 was hospitalized to our clinic with body temperature elevation, weakness, and headache persisting for the previous three days. Persistent hiccups were present during follow-up, and progression was observed at pulmonary tomography with an increase in the numbers and dimensions of focal ground glass areas. Lymphocyte count was 920/µL, platelet count 138×103/µL, sedimentation rate 6 mm/h, ferritin 1256 ng/mL, C-reactive protein 16.8 mg/L, aspartate aminotransferase 43 U/L, alanine aminotransferase 67 U/L, and lactate dehydrogenase 326 U/L. Other potential causes of persistent hiccups were excluded. COVID-19 immune plasma and remdesivir therapy were initiated. The hiccups resolved two days after treatment, and the patient was discharged on the 11th day of follow-up. Persistent hiccups should be remembered among the symptoms that may appear during the clinical progression of COVID-19.

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COVID-19 and stroke: from the cases to the causes

Frisullo

Scala

Bellavia

et al. 2021

Reviews in the Neurosciences

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During COVID-19 pandemic, a wide variety of stroke typologies have been described in patients affected by SARS-CoV-2. Investigating the case reports of acute stroke in COVID-19 patients, published since the beginning of the pandemic, we tried to trace the pathogenic mechanisms of stroke during SARS-CoV-2 infection. We conducted a systematic review analyzing demographic data, cerebrovascular risk factors, NIHSS score, vascular territory involvement and laboratory findings of 168 patients described in 89 studies, from a pool of 1243 records. Based on our results, we have identified different stroke profiles: (1) cerebral large vessel disease (CLVD) profile with a low disability, simultaneous onset of COVID-19 and stroke symptoms, good outcome and low serum levels of D-dimer and CRP; (2) intracranial bleeding (IB) profile with high disability, poor outcome and low levels of serum markers of inflammation and coagulopathy; (3) CLVD profile with a short time-lapse between COVID-19 symptoms and stroke onset, high neurological disability and very high systemic inflammatory markers; (4) multiple thrombo-embolic disease (MTED) profile with older patients, many comorbidities, disabling stroke, poor outcome, evident alteration of coagulation tests and high serum levels of both D-dimer and CRP. We therefore summarized these different profiles in a spectrum similar to that of visible light, where the violet–blue band included IB and CSVD with low inflammation and prothrombotic activity, the green–yellow band included CLVD with high inflammation and moderate prothrombotic activity and the orange–red band for MTED with moderate-high levels of inflammation and very high prothrombotic activity.

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Cerebral Infarction in an Elderly Patient with Coronavirus Disease

Abstract: FIGURE 1: Axial section non-contrast computed tomography showing widespread ground-glass opacities and crazy paving patterns in the bilateral lungs (arrows).

Cited by 5 publications

References 2 publications

Clinical Characteristics of Stroke with COVID-19: A Systematic Review and Meta-Analysis

Clinical Characteristics of Stroke with COVID-19: A Systematic Review and Meta-Analysis

Can persistent hiccups be a progression marker in COVID-19?

COVID-19 and stroke: from the cases to the causes

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