Cargando…
Covid-19 associated free hanging clots in acute symptomatic carotid stenosis
BACKGROUND: Thrombotic complications including stroke were previously described following Covid-19. We aim to describe the clinical and radiological characteristics of Covid-19 related with acutely symptomatic carotid stenosis (aSCS). METHOD: All patients presenting with an aSCS were prospectively e...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier B.V.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715260/ https://www.ncbi.nlm.nih.gov/pubmed/36493703 http://dx.doi.org/10.1016/j.jns.2022.120515 |
_version_ | 1784842408628846592 |
---|---|
author | Schwartzmann, Y. Leker, R.R. Filioglo, A. Molad, J. Cohen, J.E. Honig, A. |
author_facet | Schwartzmann, Y. Leker, R.R. Filioglo, A. Molad, J. Cohen, J.E. Honig, A. |
author_sort | Schwartzmann, Y. |
collection | PubMed |
description | BACKGROUND: Thrombotic complications including stroke were previously described following Covid-19. We aim to describe the clinical and radiological characteristics of Covid-19 related with acutely symptomatic carotid stenosis (aSCS). METHOD: All patients presenting with an aSCS were prospectively enrolled in an ongoing institutional database. Inclusion criteria for the Covid-19-aSCS group were a combination of both antigen test and a positive reverse-transcriptase (PCR) test for Covid-19 upon admission. Patients with additional potential etiologies for stroke including cardioembolism, carotid dissection or patients with stenosis of <50% on CTA were excluded. A cohort of non-Covid-19 related aSCS patients admitted to the same institution before the pandemic during 2019 served as controls. RESULTS: Compared to controls (n = 31), Covid-19-aSCS (n = 8), were younger (64.2 ± 10.7 vs 73.5 ± 10, p = 0.027), and less frequently had hypertension (50% vs 90%, p = 0.008) or hyperlipidemia (38% vs 77%, p = 0.029) before admission. Covid-19-aSCS patients had a higher admission NIHSS score (mean 9 ± 7 vs 3 ± 4, p = 0.004) and tended to present more often with stroke (88% vs 55%, p = 0.09) rather than a TIA. Covid-19-aSCS patients had higher rates of free-floating thrombus and clot burden on CTA (88% vs 6.5%, p = 0.002). Covid-19 patients also less often achieved excellent outcomes, with lower percentage of mRS score of 0 after 90-days (13% vs 58%, p = 0.022). CONCLUSION: Covid-19- aSCS may occur in a younger and healthier subpopulation. Covid-19- aSCS patients may have higher tendencies for developing complex clots and less often achieve excellent outcomes. |
format | Online Article Text |
id | pubmed-9715260 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Elsevier B.V. |
record_format | MEDLINE/PubMed |
spelling | pubmed-97152602022-12-02 Covid-19 associated free hanging clots in acute symptomatic carotid stenosis Schwartzmann, Y. Leker, R.R. Filioglo, A. Molad, J. Cohen, J.E. Honig, A. J Neurol Sci Clinical Short Communication BACKGROUND: Thrombotic complications including stroke were previously described following Covid-19. We aim to describe the clinical and radiological characteristics of Covid-19 related with acutely symptomatic carotid stenosis (aSCS). METHOD: All patients presenting with an aSCS were prospectively enrolled in an ongoing institutional database. Inclusion criteria for the Covid-19-aSCS group were a combination of both antigen test and a positive reverse-transcriptase (PCR) test for Covid-19 upon admission. Patients with additional potential etiologies for stroke including cardioembolism, carotid dissection or patients with stenosis of <50% on CTA were excluded. A cohort of non-Covid-19 related aSCS patients admitted to the same institution before the pandemic during 2019 served as controls. RESULTS: Compared to controls (n = 31), Covid-19-aSCS (n = 8), were younger (64.2 ± 10.7 vs 73.5 ± 10, p = 0.027), and less frequently had hypertension (50% vs 90%, p = 0.008) or hyperlipidemia (38% vs 77%, p = 0.029) before admission. Covid-19-aSCS patients had a higher admission NIHSS score (mean 9 ± 7 vs 3 ± 4, p = 0.004) and tended to present more often with stroke (88% vs 55%, p = 0.09) rather than a TIA. Covid-19-aSCS patients had higher rates of free-floating thrombus and clot burden on CTA (88% vs 6.5%, p = 0.002). Covid-19 patients also less often achieved excellent outcomes, with lower percentage of mRS score of 0 after 90-days (13% vs 58%, p = 0.022). CONCLUSION: Covid-19- aSCS may occur in a younger and healthier subpopulation. Covid-19- aSCS patients may have higher tendencies for developing complex clots and less often achieve excellent outcomes. Elsevier B.V. 2023-01-15 2022-12-02 /pmc/articles/PMC9715260/ /pubmed/36493703 http://dx.doi.org/10.1016/j.jns.2022.120515 Text en © 2022 Elsevier B.V. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. |
spellingShingle | Clinical Short Communication Schwartzmann, Y. Leker, R.R. Filioglo, A. Molad, J. Cohen, J.E. Honig, A. Covid-19 associated free hanging clots in acute symptomatic carotid stenosis |
title | Covid-19 associated free hanging clots in acute symptomatic carotid stenosis |
title_full | Covid-19 associated free hanging clots in acute symptomatic carotid stenosis |
title_fullStr | Covid-19 associated free hanging clots in acute symptomatic carotid stenosis |
title_full_unstemmed | Covid-19 associated free hanging clots in acute symptomatic carotid stenosis |
title_short | Covid-19 associated free hanging clots in acute symptomatic carotid stenosis |
title_sort | covid-19 associated free hanging clots in acute symptomatic carotid stenosis |
topic | Clinical Short Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715260/ https://www.ncbi.nlm.nih.gov/pubmed/36493703 http://dx.doi.org/10.1016/j.jns.2022.120515 |
work_keys_str_mv | AT schwartzmanny covid19associatedfreehangingclotsinacutesymptomaticcarotidstenosis AT lekerrr covid19associatedfreehangingclotsinacutesymptomaticcarotidstenosis AT filiogloa covid19associatedfreehangingclotsinacutesymptomaticcarotidstenosis AT moladj covid19associatedfreehangingclotsinacutesymptomaticcarotidstenosis AT cohenje covid19associatedfreehangingclotsinacutesymptomaticcarotidstenosis AT honiga covid19associatedfreehangingclotsinacutesymptomaticcarotidstenosis |