Characteristics of Large-Vessel Occlusion Associated with COVID-19 and Ischemic Stroke

The mechanisms and phenotype of ischemic stroke associated with coronavirus disease 2019 (COVID-19) remain uncertain. A retrospective study was conducted in patients with COVID-19 presenting with ischemic stroke from March 1 to May 25, 2020, and cases with large-vessel occlusion were identified. To...

Full description

Saved in:

Bibliographic Details
Published in:	American journal of neuroradiology : AJNR Vol. 41; no. 12; pp. 2263 - 2268
Main Authors:	John, Seby, Kesav, Praveen, Mifsud, Victoria Ann, Piechowski-Jozwiak, Bartlomiej, Dibu, Jamil, Bayrlee, Ahmad, Elkambergy, Hussam, Roser, Florian, Elhammady, Mohamed Samy, Zahra, Khalil, Hussain, Syed Irteza
Format:	Journal Article
Language:	English
Published:	United States American Society of Neuroradiology 01-12-2020
Subjects:	Cerebrovascular Disorders - epidemiology Cerebrovascular Disorders - pathology Cerebrovascular Disorders - virology COVID-19 - complications Fellows' Journal Club Female Humans Interventional Ischemic Stroke - complications Ischemic Stroke - pathology Male Middle Aged Retrospective Studies SARS-CoV-2
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	The mechanisms and phenotype of ischemic stroke associated with coronavirus disease 2019 (COVID-19) remain uncertain. A retrospective study was conducted in patients with COVID-19 presenting with ischemic stroke from March 1 to May 25, 2020, and cases with large-vessel occlusion were identified. To provide baseline institutional stroke data within and outside the COVID-19 pandemic, all consecutive ischemic stroke and TIA admissions (COVID and non-COVID) to the hospital during a 10-week period from March 1 to May 10, 2020, were collected and compared with data from the same time period in 2019. Among 20 patients with COVID-19 and acute ischemic stroke, 15 (75%) had large-vessel occlusion. These patients were young (mean age, 46.5 years), male (93%), without major burden of traditional cardiovascular risk factors, and had a severe stroke presentation. Large-vessel occlusions were observed in multiple vessels (40%), uncommonly affected vessels, and atypical locations with a large thrombus burden. Systemic thrombosis separate from large-vessel occlusion was not uncommon (26%). At short-term follow-up, stroke etiology remained undetermined in 46% of patients and functional outcome was poor. The above findings raise the possibility of stroke related to mechanisms induced by the COVID-19 infection itself, including a hypercoagulable state and/or endothelial damage. In addition, they document the severe presentation and poor outcomes of large-vessel occlusion in COVID-19 ischemic stroke.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23
ISSN:	0195-6108 1936-959X
DOI:	10.3174/ajnr.A6799