A review on SARS-CoV-2 and stroke pathogenesis and outcome

Abstract

Severe acute respiratory syndrome corona virus 2 hit strongly and hardly the entire globe for more than 1 year with a morbidity exceeding 139 million and a mortality approaching 3 million worldwide since its emergence in China in December 2019 until April 2021.Although being termed after its ancestor the acute respiratory syndrome corona virus that emerged in 2002. Yet, the current corona virus has its unique devastating presentations being pulmonary and extra pulmonary.In the current review, a highlight on the role played by corona virus 2 on pathogenesis and outcome of stroke is presented with an attempt to point to the most approved ways through which the corona virus induce stroke being disturbance in renin angiotensin system and angiotensin-converting enzyme 2 receptors downregulation, endothelial cell damage with coagulopathy, cytokine storm, and platelet as well as outcome and risks in patients who are suffering stroke with modifiable vascular risk factors and catching the severe acute respiratory syndrome corona virus 2.

Neurological sequelae of COVID-19: a review

“…Reported sensations of “nasal burning” could suggest involvement of the trigeminal nerve [ 29 ]. ACE receptors have been widely discussed as a possible receptor in COVID-19 pathogenesis and their presence in CNS tissue may explain COVID-19 associated neurological disease [ 23 , 30 ]. Furthermore, lower sensory impairment in children with COVID-19 may correlate with age-related expression of ACE2 [ 31 ].…”

“…Stroke and COVID-19 are of concern due to hypercoagulable states induced by COVID-19 infection [ 106 ] and possible infection of vasculoendothelial cells [ 23 , 38 ]. Furthermore, limitations in health resources due to the pandemic, suggested by markedly decreased rates of stroke admission and emergency care early in the pandemic, may also indirectly contribute to long-term effects of stroke in non-COVID-19 patients [ 107 , 108 ].…”

“…Residual pathology may also result from cardiovascular issues during acute illness, such as stroke [ 4 , 18 , 19 ]. Indeed, D-dimer, plasminogen activator inhibitor 1 (PAI-1), and Von Willebrand factor (VWF) are elevated in COVID-19 patients and may indicate hypercoagulable states and/or endothelial damage that can lead to stroke and other vascular complications [ 20 – 23 ]. SARS-CoV-2 may also induce host production of autoantibodies that can cause pathologies, such as Guillan–Barre syndrome [ 5 ].…”

A case series of post COVID-19 mucormycosis—a neurological prospective

“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is besieging the world for more than a year since its declaration by the World Health Organization as a pandemic in March 2020. Its effect on central nervous system has been reported along many studies and reviews either through affecting vascular system in different ways leading to strokes [ 1 ] or through retrograde extension to the brain through the olfactory nerve [ 2 ].…”

Pathophysiology of SARS-CoV-2-associated ischemic stroke is variegated

“…With interest we read the review article by Roushdy et al about the pathophysiological mechanisms involved in the development of SARS-CoV-2-associated stroke [ 1 ]. SARS-CoV-2-associated stroke mechanisms discussed were affection of the renin angiotensin system and angiotensin-converting enzyme 2 (ACE-2) receptor downregulation, endothelial cell damage with coagulopathy, cytokine storm, and platelet dysfunction [ 1 ]. The review is appealing but raises the following comments and concerns.…”