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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
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Intraluminal Carotid Artery Thrombus in COVID-19: Another Danger of Cytokine Storm?

A Y Mohamud1, B Griffith2, M Rehman1

  • 1From the Departments of Neurology (A.Y.M., M.R., D.M., A.C., B.H.).

AJNR. American Journal of Neuroradiology
|July 4, 2020
PubMed

Insights

Severe COVID-19 causes inflammation, increasing stroke risk. This study found that coronavirus disease 2019 (COVID-19) patients experienced acute ischemic stroke due to carotid artery thrombus, highlighting a critical link between severe inflammation and cerebrovascular events.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Cardiovascular Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to severe inflammatory responses.
  • Inflammation can destabilize atherosclerotic plaques and create a pro-thrombotic state.
  • Acute ischemic stroke is a serious neurological complication.

Purpose of the Study:

  • To report a series of patients with COVID-19 who developed acute ischemic stroke.
  • To investigate the potential link between COVID-19-related inflammation and stroke.
  • To describe the clinical characteristics and outcomes of these patients.

Main Methods:

  • Retrospective case series of 6 patients diagnosed with COVID-19 and acute ischemic stroke.
  • Analysis of patient demographics, vascular risk factors, and COVID-19 diagnostic methods.
  • Review of laboratory markers of inflammation (D-dimer, C-reactive protein, LDH, ferritin, IL-6, troponin) and stroke severity (NIHSS).

Main Results:

  • Six patients (5 male, mean age 65.8 years) presented with acute ischemic stroke and COVID-19 within an 8-day period.
  • All patients had vascular risk factors; four presented with large infarcts (NIHSS 24-30).
  • Elevated inflammatory markers (D-dimer, CRP, LDH, ferritin, IL-6, troponin) were observed in most patients.

Conclusions:

  • COVID-19-associated inflammation may trigger atherosclerotic plaque rupture.
  • This process can lead to carotid artery thrombosis and subsequent acute ischemic stroke.
  • The findings suggest a need for vigilance regarding cerebrovascular complications in COVID-19 patients.

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