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Cerebral ischemic and hemorrhagic complications of coronavirus disease 2019

BACKGROUND: The coronavirus disease 2019 is associated with neurological manifestations including stroke. OBJECTIVES: We present a case series of coronavirus disease 2019 patients from two institutions with acute cerebrovascular pathologies. In addition, we present a pooled analysis of published dat...

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Autores principales: Sweid, Ahmad, Hammoud, Batoul, Bekelis, Kimon, Missios, Symeon, Tjoumakaris, Stavropoula I, Gooch, Michael R, Herial, Nabeel A, Zarzour, Hekmat, Romo, Victor, DePrince, Maureen, Rosenwasser, Robert H, Jabbour, Pascal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7534206/
https://www.ncbi.nlm.nih.gov/pubmed/32501751
http://dx.doi.org/10.1177/1747493020937189
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author Sweid, Ahmad
Hammoud, Batoul
Bekelis, Kimon
Missios, Symeon
Tjoumakaris, Stavropoula I
Gooch, Michael R
Herial, Nabeel A
Zarzour, Hekmat
Romo, Victor
DePrince, Maureen
Rosenwasser, Robert H
Jabbour, Pascal
author_facet Sweid, Ahmad
Hammoud, Batoul
Bekelis, Kimon
Missios, Symeon
Tjoumakaris, Stavropoula I
Gooch, Michael R
Herial, Nabeel A
Zarzour, Hekmat
Romo, Victor
DePrince, Maureen
Rosenwasser, Robert H
Jabbour, Pascal
author_sort Sweid, Ahmad
collection PubMed
description BACKGROUND: The coronavirus disease 2019 is associated with neurological manifestations including stroke. OBJECTIVES: We present a case series of coronavirus disease 2019 patients from two institutions with acute cerebrovascular pathologies. In addition, we present a pooled analysis of published data on large vessel occlusion in the setting of coronavirus disease 2019 and a concise summary of the pathophysiology of acute cerebrovascular disease in the setting of coronavirus disease 2019. METHODS: A retrospective study across two institutions was conducted between 20 March 2020 and 20 May 2020, for patients developing acute cerebrovascular disease and diagnosed with coronavirus disease 2019. We performed a literature review using the PubMed search engine. RESULTS: The total sample size was 22 patients. The mean age was 59.5 years, and 12 patients were female. The cerebrovascular pathologies were 17 cases of acute ischemic stroke, 3 cases of aneurysm rupture, and 2 cases of sinus thrombosis. Of the stroke and sinus thrombosis patients, the mean National Institute of Health Stroke Scale was 13.8 ± 8.0, and 16 (84.2%) patients underwent a mechanical thrombectomy procedure. A favorable thrombolysis in cerebral infarction score was achieved in all patients. Of the 16 patients that underwent a mechanical thrombectomy, the mortality incidence was five (31.3%). Of all patients (22), three (13.6%) patients developed hemorrhagic conversion requiring decompressive surgery. Eleven (50%) patients had a poor functional status (modified Rankin Score 3–6) at discharge, and the total mortality incidence was eight (36.4%). CONCLUSIONS: Despite timely intervention and favorable reperfusion, the mortality rate in coronavirus disease 2019 patients with large vessel occlusion was high in our series and in the pooled analysis. Notable features were younger age group, involvement of both the arterial and venous vasculature, multivessel involvement, and complicated procedures due to the clot consistency and burden.
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spelling pubmed-75342062020-10-14 Cerebral ischemic and hemorrhagic complications of coronavirus disease 2019 Sweid, Ahmad Hammoud, Batoul Bekelis, Kimon Missios, Symeon Tjoumakaris, Stavropoula I Gooch, Michael R Herial, Nabeel A Zarzour, Hekmat Romo, Victor DePrince, Maureen Rosenwasser, Robert H Jabbour, Pascal Int J Stroke Research BACKGROUND: The coronavirus disease 2019 is associated with neurological manifestations including stroke. OBJECTIVES: We present a case series of coronavirus disease 2019 patients from two institutions with acute cerebrovascular pathologies. In addition, we present a pooled analysis of published data on large vessel occlusion in the setting of coronavirus disease 2019 and a concise summary of the pathophysiology of acute cerebrovascular disease in the setting of coronavirus disease 2019. METHODS: A retrospective study across two institutions was conducted between 20 March 2020 and 20 May 2020, for patients developing acute cerebrovascular disease and diagnosed with coronavirus disease 2019. We performed a literature review using the PubMed search engine. RESULTS: The total sample size was 22 patients. The mean age was 59.5 years, and 12 patients were female. The cerebrovascular pathologies were 17 cases of acute ischemic stroke, 3 cases of aneurysm rupture, and 2 cases of sinus thrombosis. Of the stroke and sinus thrombosis patients, the mean National Institute of Health Stroke Scale was 13.8 ± 8.0, and 16 (84.2%) patients underwent a mechanical thrombectomy procedure. A favorable thrombolysis in cerebral infarction score was achieved in all patients. Of the 16 patients that underwent a mechanical thrombectomy, the mortality incidence was five (31.3%). Of all patients (22), three (13.6%) patients developed hemorrhagic conversion requiring decompressive surgery. Eleven (50%) patients had a poor functional status (modified Rankin Score 3–6) at discharge, and the total mortality incidence was eight (36.4%). CONCLUSIONS: Despite timely intervention and favorable reperfusion, the mortality rate in coronavirus disease 2019 patients with large vessel occlusion was high in our series and in the pooled analysis. Notable features were younger age group, involvement of both the arterial and venous vasculature, multivessel involvement, and complicated procedures due to the clot consistency and burden. SAGE Publications 2020-06-26 2020-10 /pmc/articles/PMC7534206/ /pubmed/32501751 http://dx.doi.org/10.1177/1747493020937189 Text en © 2020 World Stroke Organization https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Research
Sweid, Ahmad
Hammoud, Batoul
Bekelis, Kimon
Missios, Symeon
Tjoumakaris, Stavropoula I
Gooch, Michael R
Herial, Nabeel A
Zarzour, Hekmat
Romo, Victor
DePrince, Maureen
Rosenwasser, Robert H
Jabbour, Pascal
Cerebral ischemic and hemorrhagic complications of coronavirus disease 2019
title Cerebral ischemic and hemorrhagic complications of coronavirus disease 2019
title_full Cerebral ischemic and hemorrhagic complications of coronavirus disease 2019
title_fullStr Cerebral ischemic and hemorrhagic complications of coronavirus disease 2019
title_full_unstemmed Cerebral ischemic and hemorrhagic complications of coronavirus disease 2019
title_short Cerebral ischemic and hemorrhagic complications of coronavirus disease 2019
title_sort cerebral ischemic and hemorrhagic complications of coronavirus disease 2019
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7534206/
https://www.ncbi.nlm.nih.gov/pubmed/32501751
http://dx.doi.org/10.1177/1747493020937189
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