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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...

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Autores principales: Schwartzmann, Y., Leker, R.R., Filioglo, A., Molad, J., Cohen, J.E., Honig, A.
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
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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.
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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
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