Acute Ischemic Stroke in COVID-19: A Case-Based Systematic Review.

Area of Science:

• Neurology
• Infectious Diseases
• Hematology

Background:

• Coronavirus disease (COVID-19) has become a global pandemic.
• Acute ischemic stroke (AIS) is an emerging neurological complication of COVID-19.
• COVID-19 associated AIS presents with severe immune responses, dysregulated coagulation, and thrombo-embolic events, affecting even younger individuals.

Purpose of the Study:

• To review clinical data of patients with both COVID-19 and AIS.
• To understand the clinical, laboratory, and imaging features of COVID-19 associated AIS.
• To investigate the correlation between inflammatory markers and AIS outcomes in COVID-19 patients.

Main Methods:

• Systematic review of published literature on COVID-19 and concomitant AIS cases.
• Analysis of clinical, laboratory (including NLR, C-Reactive protein, ferritin, D-dimer, fibrinogen), and imaging data.
• Correlation analysis between inflammatory markers and AIS onset/prognosis.

Main Results:

• Neutrophil-lymphocyte ratio (NLR) positively correlates with the time to AIS onset after COVID-19 infection.
• Elevated NLR, C-Reactive protein, serum ferritin, D-dimer, and fibrinogen levels are associated with poor prognosis.
• Approximately 75% of patients with COVID-19 and AIS experienced severe disability or death.

Conclusions:

• COVID-19 poses a significant risk for acute ischemic stroke, particularly in younger populations.
• Inflammatory markers like NLR are crucial indicators of AIS severity and prognosis in COVID-19 patients.
• Further research is needed to determine long-term outcomes for survivors of COVID-19 associated AIS.