Related Experiment Video
Updated: Dec 20, 2025
Live Imaging and Quantification of Viral Infection in K18 hACE2 Transgenic Mice Using Reporter-Expressing Recombinant SARS-CoV-2
Published on: November 5, 2021
Ischaemic stroke and SARS-CoV-2 infection: A causal or incidental association?
J M Barrios-López1, I Rego-García1, C Muñoz Martínez1
1Servicio de Neurología, Hospital Universitario Virgen de las Nieves, Granada, España.
Insights
COVID-19 may cause ischaemic stroke through systemic inflammation and hypercoagulability, particularly in severe cases. Further research is needed to confirm this link and guide patient management.
Area of Science:
- Neurology
- Infectious Diseases
- Cardiology
Background:
- Ischaemic stroke is a known complication in some COVID-19 patients.
- The link between COVID-19, systemic inflammation, and hypercoagulability leading to stroke requires clarification.
Observation:
- Four patients with ischaemic stroke and COVID-19 were analyzed.
- Two patients showed a probable causal link between hypercoagulability and stroke, presenting with cortical infarcts and inflammation.
- Two other patients, older with cardioembolic stroke, had an incidental association with COVID-19.
Findings:
- COVID-19-associated systemic inflammation and potential viral effects may lead to endothelial dysfunction and hypercoagulability.
- This hypercoagulable state is a potential mechanism for ischaemic stroke in COVID-19 patients.
- Stroke pathogenesis in COVID-19 is multifactorial.
Implications:
- Larger studies are required to validate the proposed mechanisms linking COVID-19 to ischaemic stroke.
- Comprehensive etiological investigation is crucial for managing stroke patients with COVID-19.
- Safety precautions are essential during the management of these patients.
Introduction:
Ischaemic stroke has been reported in patients with COVID-19, particularly in more severe cases. However, it is unclear to what extent this is linked to systemic inflammation and hypercoagulability secondary to the infection.
Methods:
We describe the cases of 4 patients with ischaemic stroke and COVID-19 who were attended at our hospital. Patients are classified according to the likelihood of a causal relationship between the hypercoagulable state and ischaemic stroke. We also conducted a review of studies addressing the possible mechanisms involved in the aetiopathogenesis of ischaemic stroke in these patients.
Results:
The association between COVID-19 and stroke was probably causal in 2 patients, who presented cortical infarcts and had no relevant arterial or cardioembolic disease, but did show signs of hypercoagulability and systemic inflammation in laboratory analyses. The other 2 patients were of advanced age and presented cardioembolic ischaemic stroke; the association in these patients was probably incidental.
Conclusions:
Systemic inflammation and the potential direct action of the virus may cause endothelial dysfunction, resulting in a hypercoagulable state that could be considered a potential cause of ischaemic stroke. However, stroke involves multiple pathophysiological mechanisms; studies with larger samples are therefore needed to confirm our hypothesis. The management protocol for patients with stroke and COVID-19 should include a complete aetiological study, with the appropriate safety precautions always being observed.
Related Concept Videos
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...
01:05Single Nucleotide Polymorphisms-SNPs
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
01:26Coronary Artery Disease II: Pathophysiology
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...