COVID-19 and Stroke: Casual or Causal Role?

被引:16
作者
Saggese, Carlo Emanuele [1 ]
Del Bianco, Chiara [1 ]
Di Ruzza, Maria Rita [1 ]
Magarelli, Maria [1 ]
Gandini, Roberto [2 ]
Plocco, Maurizio [1 ]
机构
[1] F Spaziani Hosp, UTN Neurovasc Therapy Unit, Frosinone, Italy
[2] Policlin Tor Vergata PTV, Intervent Radiol, Rome, Italy
关键词
COVID-19; Acute stroke thrombolysis; Acute stroke management; Angioplasty;
D O I
10.1159/000509453
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background:The COVID-19 outbreak is currently the major public health concern worldwide. This infection, caused by the novel coronavirus Sars Cov2, primarily affects respiratory system, but there is increasing evidence of neurologic involvement and cerebrovascular accidents.Case Report:We present a case of stroke in a 62-year-old COVID-19-positive patient, with multiple vascular risk factors. The patient arrived 1 h after onset of symptoms, was treated with recombinant tissue plasminogen activator (rtPA) with improvement of neurologic deficits, and later developed right foot arterial ischemia (recanalized by balloon catheter angioplasty) and left arm superficial venous thrombosis. A control computed tomography (CT) scan 7 days after onset showed hemorrhagic transformation of ischemic lesion without mass effect. However, respiratory and neurologic conditions improved so that the patient was discharged to rehabilitation.Discussion:Until now, few cases of stroke in COVID-19 have been described, mainly in severe forms. This patient had ischemic injuries in different sites as well as venous thrombosis; hence, we speculate that Sars Cov2 could have a direct role in promoting vascular accidents since its receptor ACE2 is a surface protein also expressed by endothelial cells. This case suggests that COVID-19 can favor strokes and in general vascular complications, even in milder cases, and the presence of preexisting risk factors could play a determinant role.
引用
收藏
页码:341 / 344
页数:4
相关论文
共 9 条
[1]   Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study [J].
Chen, Nanshan ;
Zhou, Min ;
Dong, Xuan ;
Qu, Jieming ;
Gong, Fengyun ;
Han, Yang ;
Qiu, Yang ;
Wang, Jingli ;
Liu, Ying ;
Wei, Yuan ;
Xia, Jia'an ;
Yu, Ting ;
Zhang, Xinxin ;
Zhang, Li .
LANCET, 2020, 395 (10223) :507-513
[2]   Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis [J].
Hamming, I ;
Timens, W ;
Bulthuis, MLC ;
Lely, AT ;
Navis, GJ ;
van Goor, H .
JOURNAL OF PATHOLOGY, 2004, 203 (02) :631-637
[3]   More on Neurologic Features in Severe SARS-CoV-2 Infection [J].
Larvie, Mykol ;
Lev, Michael H. ;
Hess, Christopher P. .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (26)
[4]   Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [J].
Huang, Chaolin ;
Wang, Yeming ;
Li, Xingwang ;
Ren, Lili ;
Zhao, Jianping ;
Hu, Yi ;
Zhang, Li ;
Fan, Guohui ;
Xu, Jiuyang ;
Gu, Xiaoying ;
Cheng, Zhenshun ;
Yu, Ting ;
Xia, Jiaan ;
Wei, Yuan ;
Wu, Wenjuan ;
Xie, Xuelei ;
Yin, Wen ;
Li, Hui ;
Liu, Min ;
Xiao, Yan ;
Gao, Hong ;
Guo, Li ;
Xie, Jungang ;
Wang, Guangfa ;
Jiang, Rongmeng ;
Gao, Zhancheng ;
Jin, Qi ;
Wang, Jianwei ;
Cao, Bin .
LANCET, 2020, 395 (10223) :497-506
[5]   Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China [J].
Mao, Ling ;
Jin, Huijuan ;
Wang, Mengdie ;
Hu, Yu ;
Chen, Shengcai ;
He, Quanwei ;
Chang, Jiang ;
Hong, Candong ;
Zhou, Yifan ;
Wang, David ;
Miao, Xiaoping ;
Li, Yanan ;
Hu, Bo .
JAMA NEUROLOGY, 2020, 77 (06) :683-690
[6]   The COVID-19 Pandemic: Consideration for Brain Infection [J].
Mao, Xiao-Yuan ;
Jin, Wei-Lin .
NEUROSCIENCE, 2020, 437 :130-131
[7]  
Nagel M. A., 2010, Infectious Disorders - Drug Targets, V10, P105
[8]  
WHO, 2020, 139 WHO
[9]   Coagulopathy and Antiphospholipid Antibodies in Patients with Covid-19 [J].
Zhang, Yan ;
Xiao, Meng ;
Zhang, Shulan ;
Xia, Peng ;
Cao, Wei ;
Jiang, Wei ;
Chen, Huan ;
Ding, Xin ;
Zhao, Hua ;
Zhang, Hongmin ;
Wang, Chunyao ;
Zhao, Jing ;
Sun, Xuefeng ;
Tian, Ran ;
Wu, Wei ;
Wu, Dong ;
Ma, Jie ;
Chen, Yu ;
Zhang, Dong ;
Xie, Jing ;
Yan, Xiaowei ;
Zhou, Xiang ;
Liu, Zhengyin ;
Wang, Jinglan ;
Du, Bin ;
Qin, Yan ;
Gao, Peng ;
Qin, Xuzhen ;
Xu, Yingchun ;
Zhang, Wen ;
Li, Taisheng ;
Zhang, Fengchun ;
Zhao, Yongqiang ;
Li, Yongzhe ;
Zhang, Shuyang .
NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (17)