Letter by Albiero and Seresini Regarding Article, “SARS-CoV-2 and Stroke in a New York Healthcare System”

Albiero, Remo; Seresini, Giuseppe

doi:10.1161/strokeaha.120.031093

Cited by 2 publications

(4 citation statements)

References 5 publications

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“…The results of inflammatory and coagulation tests according to SARS‐CoV‐2 infection status have been reported in 2 of the included studies, 19,34 suggesting the presence of significant differences in acute‐phase proteins and coagulation profiles between COVID‐19 stroke patients and controls. In COVID‐19 patients with acute respiratory distress syndrome, the use of mechanical ventilation may result in increased pulmonary artery pressure, which in turn can lead to a reversal of the normal interatrial pressure gradient and increased right‐to‐left shunt gradient in patients with patent foramen ovale 38,39 . The potential of paradoxical embolism in COVID‐19 patients suffering from a cryptogenic stroke as the underlying pathophysiological mechanism is a hypothesis that deserves further investigation 39 …”

Section: Discussionmentioning

confidence: 99%

“…In COVID‐19 patients with acute respiratory distress syndrome, the use of mechanical ventilation may result in increased pulmonary artery pressure, which in turn can lead to a reversal of the normal interatrial pressure gradient and increased right‐to‐left shunt gradient in patients with patent foramen ovale 38,39 . The potential of paradoxical embolism in COVID‐19 patients suffering from a cryptogenic stroke as the underlying pathophysiological mechanism is a hypothesis that deserves further investigation 39 …”

Section: Discussionmentioning

confidence: 99%

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The Impact of SARS‐CoV‐2 on Stroke Epidemiology and Care: A Meta‐Analysis

Katsanos

Palaiodimou

Zand

et al. 2020

Annals of Neurology

114

108

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Objective Emerging data indicate an increased risk of cerebrovascular events with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and highlight the potential impact of coronavirus disease (COVID‐19) on the management and outcomes of acute stroke. We conducted a systematic review and meta‐analysis to evaluate the aforementioned considerations. Methods We performed a meta‐analysis of observational cohort studies reporting on the occurrence and/or outcomes of patients with cerebrovascular events in association with their SARS‐CoV‐2 infection status. We used a random‐effects model. Summary estimates were reported as odds ratios (ORs) and corresponding 95% confidence intervals (CIs). Results We identified 18 cohort studies including 67,845 patients. Among patients with SARS‐CoV‐2, 1.3% (95% CI = 0.9–1.6%, I2 = 87%) were hospitalized for cerebrovascular events, 1.1% (95% CI = 0.8–1.3%, I2 = 85%) for ischemic stroke, and 0.2% (95% CI = 0.1–0.3%, I2 = 64%) for hemorrhagic stroke. Compared to noninfected contemporary or historical controls, patients with SARS‐CoV‐2 infection had increased odds of ischemic stroke (OR = 3.58, 95% CI = 1.43–8.92, I2 = 43%) and cryptogenic stroke (OR = 3.98, 95% CI = 1.62–9.77, I2 = 0%). Diabetes mellitus was found to be more prevalent among SARS‐CoV‐2 stroke patients compared to noninfected historical controls (OR = 1.39, 95% CI = 1.00–1.94, I2 = 0%). SARS‐CoV‐2 infection status was not associated with the likelihood of receiving intravenous thrombolysis (OR = 1.42, 95% CI = 0.65–3.10, I2 = 0%) or endovascular thrombectomy (OR = 0.78, 95% CI = 0.35–1.74, I2 = 0%) among hospitalized ischemic stroke patients during the COVID‐19 pandemic. Odds of in‐hospital mortality were higher among SARS‐CoV‐2 stroke patients compared to noninfected contemporary or historical stroke patients (OR = 5.60, 95% CI = 3.19–9.80, I2 = 45%). Interpretation SARS‐CoV‐2 appears to be associated with an increased risk of ischemic stroke, and potentially cryptogenic stroke in particular. It may also be related to an increased mortality risk. ANN NEUROL 2021;89:380–388

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Impact of SARS‐CoV‐2 on Stroke Epidemiology and Care: A Meta‐Analysis

Katsanos

Palaiodimou

Zand

et al. 2020

Annals of Neurology

114

108

View full text Add to dashboard Cite

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“…In den meisten Fällen wurden diese Schlaganfälle als kryptogen klassifiziertwobei einschränkend hinzugefügt werden muss, dass häufig keine vollständige diagnostische Aufarbeitung erfolgt war [63,64]. Insbesondere die Möglichkeit paradoxer Embolien infolge eines persistierenden Foramen ovale wurde häufig nicht ausreichend geklärt, ist aber vor dem Hintergrund der bei COVID-19 vermehrten venösen Thromboembolien von besonderem Interesse [65]. Neben der überschießenden Gerinnung sind u. a. auch vaskulitische Prozesse und eine SARS-CoV-2induzierte Kardiomyopathie an der Pathogenese COVID-19-assoziierter ischämischer Schlaganfälle beteiligt [66].…”

Section: Reviewunclassified

“…However, it must be added as a limitation that a complete diagnostic workup was often not performed 63 64 . In particular, the possibility of paradoxical embolisms due to a persistent foramen ovale has often not been sufficiently clarified but is of particular interest in light of the increase in venous thromboembolisms seen in COVID-19 65 . In addition to hypercoagulation, vasculitic processes and SARS-CoV-2-induced cardiomyopathy are also involved in the pathogenesis of COVID-19-associated ischemic stroke 66 .…”

Section: Extrapulmonary Manifestationsmentioning

confidence: 99%

One year of COVID-19 pandemic: what we Radiologists have learned about imaging

Groß

Albrecht

2021

Rofo

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Background Since its outbreak in December 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected more than 151 million people worldwide. More than 3.1 million have died from Coronavirus Disease 2019 (COVID-19), the illness caused by SARS-CoV-2. The virus affects mainly the upper respiratory tract and the lungs causing pneumonias of varying severity. Moreover, via direct and indirect pathogenetic mechanisms, SARS-CoV-2 may lead to a variety of extrapulmonary as well as vascular manifestations. Methods Based on a systematic literature search via PubMed, original research articles, meta-analyses, reviews, and case reports representing the current scientific knowledge regarding diagnostic imaging of COVID-19 were selected. Focusing on the imaging appearance of pulmonary and extrapulmonary manifestations as well as indications for imaging, these data were summarized in the present review article and correlated with basic pathophysiologic mechanisms. Results and Conclusion Typical signs of COVID-19 pneumonia are multifocal, mostly bilateral, rounded, polycyclic or geographic ground-glass opacities and/or consolidations with mainly peripheral distribution. In severe cases, peribronchovascular lung zones are affected as well. Other typical signs are the “crazy paving” pattern and the halo and reversed halo (the latter two being less common). Venous thromboembolism (and pulmonary embolism in particular) is the most frequent vascular complication of COVID-19. However, arterial thromboembolic events like ischemic strokes, myocardial infarctions, and systemic arterial emboli also occur at higher rates. The most frequent extrapulmonary organ manifestations of COVID-19 affect the central nervous system, the heart, the hepatobiliary system, and the gastrointestinal tract. Usually, they can be visualized in imaging studies as well. The most important imaging modality for COVID-19 is chest CT. Its main purpose is not to make the primary diagnosis, but to differentiate COVID-19 from other (pulmonary) pathologies, to estimate disease severity, and to detect concomitant diseases and complications. Key Points: Citation Format

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Letter by Albiero and Seresini Regarding Article, “SARS-CoV-2 and Stroke in a New York Healthcare System”

Cited by 2 publications

References 5 publications

The Impact of SARS‐CoV‐2 on Stroke Epidemiology and Care: A Meta‐Analysis

The Impact of SARS‐CoV‐2 on Stroke Epidemiology and Care: A Meta‐Analysis

One year of COVID-19 pandemic: what we Radiologists have learned about imaging

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