Coexistence of COVID-19 and acute ischemic stroke report of four cases

•COVID-19 has neuro-invasion potential independently of the critical disease process.•Cerebrovascular diseases such as ischemia may develop in the course of disease.•Increased inflammation may be predicted by CRP and D-dimer levels.•The elder Covid-19 patients with prothrombotic risk factors should...

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Published in:Journal of clinical neuroscience Vol. 77; pp. 227 - 229
Main Authors: TUNÇ, Abdulkadir, ÜNLÜBAŞ, Yonca, ALEMDAR, Murat, AKYÜZ, Enes
Format: Journal Article
Language:English
Published: Scotland Elsevier Ltd 01.07.2020
Subjects:
Aged
Betacoronavirus
Biomarkers - metabolism
Brain Ischemia - complications
Brain Ischemia - metabolism
C-Reactive Protein - metabolism
Coronavirus
Coronavirus Infections - complications
COVID-19
Female
Fibrin Fibrinogen Degradation Products - metabolism
Humans
Inflammation - complications
Inflammation - metabolism
Ischemia
Male
Middle Aged
Pandemics
Pneumonia, Viral - complications
Risk Factors
SARS-CoV-2
Stroke
Stroke - complications
Stroke - metabolism
Turkey
Turkey
COVID-19
Stroke
Coronavirus
Ischemia
ISSN:0967-5868, 1532-2653, 1532-2653
Online Access:Get full text
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Summary:•COVID-19 has neuro-invasion potential independently of the critical disease process.•Cerebrovascular diseases such as ischemia may develop in the course of disease.•Increased inflammation may be predicted by CRP and D-dimer levels.•The elder Covid-19 patients with prothrombotic risk factors should also be considered for the signs of stroke. Coronaviruses are revealed to target the human respiratory system mainly. However, they also have neuro-invasive abilities and might spread from the respiratory system to the central nervous system. Herein, we report four patients with COVID-19 simultaneously diagnosed with acute ischemic stroke. There were four stroke cases with simultaneously diagnosis of Covid-19 till the April 14, 2020 in the city of Sakarya, Turkey. They were aged between 45 and 77 years. All four cases were likely to have contracted the virus in Sakarya. The patients had all commonly reported symptoms of Covid-19. Three patients have elevated D-dimer levels, and two of them had high C-reactive protein (CRP) levels. They were managed symptomatically for both the infection and the stroke. Our findings suggest that ischemic cerebrovascular diseases may simultaneously develop in the course of Covid-19 independently of the critical disease process. Increased inflammation predicted by CRP and D-dimer levels may play a role in the formation of ischemia. In particular, elder patients with prothrombotic risk factors should also be considered for the signs of cerebrovascular events in addition to infectious symptoms.
Bibliography:ObjectType-Case Study-2
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ISSN:0967-5868
1532-2653
1532-2653
DOI:10.1016/j.jocn.2020.05.018