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Tytuł pozycji:

Stroke in patients with SARS-CoV-2 infection: case series.

Tytuł :
Stroke in patients with SARS-CoV-2 infection: case series.
Autorzy :
Morassi M; Unit of Neuroradiology, Department of Diagnostic Imaging, Istituto Ospedaliero Fondazione Poliambulanza, Via L. Bissolati 57, 25124, Brescia, Italy. .
Bagatto D; Unit of Neuroradiology, Department of Diagnostic Imaging, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero Santa Maria della Misericordia, Udine, Italy.
Cobelli M; Unit of Neuroradiology, Department of Diagnostic Imaging, Istituto Ospedaliero Fondazione Poliambulanza, Via L. Bissolati 57, 25124, Brescia, Italy.
D'Agostini S; Unit of Neuroradiology, Department of Diagnostic Imaging, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero Santa Maria della Misericordia, Udine, Italy.
Gigli GL; Department of Medicine (DAME), University of Udine Medical School, Udine, Italy.; Department of Mathematics, Informatics and Physics (DMIF), University of Udine, Udine, Italy.; Clinical Neurology Unit, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero Santa Maria della Misericordia, Udine, Italy.
Bnà C; Unit of Radiology, Department of Diagnostic Imaging, Istituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy.
Vogrig A; Clinical Neurology Unit, Azienda Sanitaria Universitaria Friuli Centrale, Presidio Ospedaliero Santa Maria della Misericordia, Udine, Italy.
Pokaż więcej
Źródło :
Journal of neurology [J Neurol] 2020 Aug; Vol. 267 (8), pp. 2185-2192. Date of Electronic Publication: 2020 May 20.
Typ publikacji :
Case Reports; Journal Article; Observational Study
Język :
English
Imprint Name(s) :
Original Publication: Berlin ; New York, Springer-Verlag
MeSH Terms :
Betacoronavirus*
Coronavirus Infections/*complications
Coronavirus Infections/*diagnostic imaging
Pneumonia, Viral/*complications
Pneumonia, Viral/*diagnostic imaging
Stroke/*diagnostic imaging
Stroke/*etiology
Aged ; Aged, 80 and over ; COVID-19 ; Coronavirus Infections/therapy ; Fatal Outcome ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/therapy ; Retrospective Studies ; SARS-CoV-2 ; Stroke/therapy
References :
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Guan W-J, Ni Z-Y, Hu Y et al (2020) Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. https://doi.org/10.1056/NEJMoa2002032. (PMID: 10.1056/NEJMoa2002032322202067121484)
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Contributed Indexing :
Keywords: Brain hemorrhage; COVID-19; Cerebrovascular disease; Coronavirus; Encephalitis; Neurological complications
Entry Date(s) :
Date Created: 20200522 Date Completed: 20200722 Latest Revision: 20210216
Update Code :
20211106
PubMed Central ID :
PMC7238403
DOI :
10.1007/s00415-020-09885-2
PMID :
32436105
Czasopismo naukowe
Background: Italy is one of the most affected countries by the coronavirus disease 2019 (COVID-19). The responsible pathogen is named severe acute respiratory syndrome coronavirus (SARS-CoV-2). The clinical spectrum ranges from asymptomatic infection to severe pneumonia, leading to intensive care unit admission. Evidence of cerebrovascular complications associated with SARS-CoV-2 is limited. We herein report six patients who developed acute stroke during COVID-19 infection.
Methods: A retrospective case series of patients diagnosed with COVID-19 using reverse-transcriptase polymerase chain reaction (RT-PCR) on nasopharyngeal swabs, who developed clinical and neuroimaging evidence of acute stroke during SARS-CoV-2 infection.
Results: Six patients were identified (5 men); median age was 69 years (range 57-82). Stroke subtypes were ischemic (4, 67%) and hemorrhagic (2, 33%). All patients but one had pre-existing vascular risk factors. One patient developed encephalopathy prior to stroke, characterized by focal seizures and behavioral abnormalities. COVID-19-related pneumonia was severe (i.e., requiring critical care support) in 5/6 cases (83%). Liver enzyme alteration and lactate dehydrogenase (LDH) elevation were registered in all cases. Four patients (67%) manifested acute kidney failure prior to stroke. Four patients (67%) had abnormal coagulation tests. The outcome was poor in the majority of the patients: five died (83%) and the remaining one (17%) remained severely neurologically affected (mRS: 4).
Conclusions: Both ischemic and hemorrhagic stroke can complicate the course of COVI-19 infection. In our series, stroke developed mostly in patients with severe pneumonia and multiorgan failure, liver enzymes and LDH were markedly increased in all cases, and the outcome was poor.
Comment in: J Neurol. 2021 Feb;268(2):424-430. (PMID: 32712866)

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