The Correlation Between Stroke and Coronavirus Disease (COVID-19): Where is the Evidence?

Pittams, Ashleigh; Axiaq, Ariana; Qamar, Amna; Botezatu, Bianca; Harky, Amer

doi:10.33590/emj/20-00184

Cited by 3 publications

(5 citation statements)

References 51 publications

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“…33 Decreased consciousness levels have also been reported in people with large hemispheric infarction and reversible encephalopathy syndrome, suggesting brain endothelial dysfunction. 34,35 Understanding the different causes of disturbed consciousness is crucial as it may lead to a specific treatment. During the early outbreak, with health systems under significant challenges, a higher proportion of people becoming unconscious and deaths was noted in Hubei than in other parts of China.…”

Section: Discussionmentioning

confidence: 99%

“…Cases with encephalitis with or without SARSCoV2 identified in cerebrospinal fluid have been reported, 7,32 but evidence of a direct insult to the brain is still lacking 33 . Decreased consciousness levels have also been reported in people with large hemispheric infarction and reversible encephalopathy syndrome, suggesting brain endothelial dysfunction 34,35 . Understanding the different causes of disturbed consciousness is crucial as it may lead to a specific treatment.…”

Section: Discussionmentioning

confidence: 99%

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Association of consciousness impairment and mortality in people with COVID‐19

Xiong

Zhang

et al. 2021

Acta Neuro Scandinavica

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Background To investigate the association between impairment of consciousness and risk of death in people with COVID‐19. Methods In this multicentre retrospective study, we enrolled people with confirmed COVID‐19 from 44 hospitals in Wuhan and Sichuan, China, between 18 January and 30 March 2020. We extracted demographics, clinical, laboratory data and consciousness level (as measured by the Glasgow Coma Scale (GCS) score) from medical records. We used Cox proportional hazards regression, structural equation modelling and survival time analysis to compare people with different progressions of impaired consciousness. Results We enrolled 1,143 people (average age 51.3 ± standard deviation 17.1‐year‐old; 50.3% males), of whom 76 died. Increased mortality risk was identified in people with GCS score between 9 and 14 (hazard ratio (HR) 46.76, p < .001) and below 9 (HR 65.86, p < .001). Pathway analysis suggested a significant direct association between consciousness level and death. Other factors, including age, oxygen saturation level and pH, had indirect associations with death mediated by GCS scores. People who developed impaired consciousness more rapidly either from symptoms onset (<10 days vs. 10–19 days, p = .025, <10 days vs. ≥20 days and 10–19 days vs. ≥20 days, <.001) or deterioration of oxygen saturation (≤2 days vs.>2 days, p = .028) had shorter survival times. Conclusion Altered consciousness and its progression had a direct link with death in COVID‐19. Interactions with age, oxygen saturation level and pH suggest possible pathophysiology. Further work to confirm these findings explore prevention strategies and interventions to decrease mortality is warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of consciousness impairment and mortality in people with COVID‐19

Xiong

Zhang

et al. 2021

Acta Neuro Scandinavica

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“…Cytokines such as Tumor Necrotic Factor- (TNF-) may inhibit the fibrinolytic system leading to coagulation. 5 Compared to the non-COVID-19 population, patients with COVID-19 had a disproportionately higher stroke rate. 8 SARS-CoV-2 binds to the angiotensin-converting enzyme-2 (ACE-2) receptor to enter the human cells.…”

Section: Discussionmentioning

confidence: 99%

“…However, the role of infectious pathogens in causing cerebrovascular episodes have been underrated. 5,6 COVID-19 is primarily a respiratory disease. However, many reports suggest that this condition may lead to a hypercoagulability state and cause thrombotic events.…”

Section: Case Report Backgroundmentioning

confidence: 99%

Covid-19 as a Potential Risk Factor for Ischemic Stroke: A Case Report

Pikatan¹,

Yuliani²,

Sumada³

et al. 2022

CallNeuroJ

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Background: Corona virus disease 2019 (COVID-19) is a pandemic disease with a wide spectrum of symptoms. Neurological symptoms are often found in this disease. Stroke on the other hand is a multifactorial disease that can be caused by a lot of underlying problems. Case: We report a case of a 67 years old man with a weakness on the right side that was worsened one day before arrival in hospital and a shortness of breath. the patient had history of stroke before, and controlled hypertension. Head Ct-scan showed a stroke infarct, and Swab RT-PCR showed + SARS-CoV-2. Discussion: Infection may become the risk factor of stroke. inflammatory mediators such as TNF-a , and CRP support the procoagulant state which leads to stroke. Conclusion: COVID-19 may increase the risk of stroke due to the inflammation state that leads to procoagulant state

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“…An increase in the incidence of hemorrhagic transformation after ischemic infarcts has been observed in COVID-19 stroke patients. It has been reported that almost one in 20 patients diagnosed with COVID-19 experience a stroke thereafter (Pittams et al, 2021). The relationship between stroke and infectious diseases is complex.…”

Section: Introductionmentioning

confidence: 99%

The myocardial and neuronal infectivity of SARS-CoV-2 and detrimental outcomes

Herbert¹,

Fournier²,

Al-Shaqha

et al. 2021

Can. J. Physiol. Pharmacol.

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The epidemiological outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), alias COVID-19, began in Wuhan, Hubei, China, in late December and eventually turned into a pandemic that has led to 3.71+ million deaths and 173+ million infected cases worldwide. In addition to respiratory manifestations, COVID-19 patients with neurological and myocardial dysfunctions exhibit a higher risk of in-hospital mortality. The immune function tends to be affected by cardiovascular risk factors and is thus indirectly related to the prognosis of COVID-19 patients. Many neurological symptoms and manifestations have been reported in COVID-19 patients. However, detailed descriptions of the prevalence and characteristic features of these symptoms are restricted due to insufficient data. It is thus advisable for clinicians to be vigilant for both cardiovascular and neurological manifestations in order to detect them at an early stage to avoid inappropriate management of COVID-19 and to address the manifestations adequately. Patients with severe COVID-19 are notably more susceptible to developing cardiovascular and neurological complications than non-severe COVID-19 patients. This review focuses on the consequential outcomes of COVID-19 on cardiovascular and neuronal functions, including other influencing factors.

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The Correlation Between Stroke and Coronavirus Disease (COVID-19): Where is the Evidence?

Cited by 3 publications

References 51 publications

Association of consciousness impairment and mortality in people with COVID‐19

Association of consciousness impairment and mortality in people with COVID‐19

Covid-19 as a Potential Risk Factor for Ischemic Stroke: A Case Report

The myocardial and neuronal infectivity of SARS-CoV-2 and detrimental outcomes

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