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Implications of COVID-19 to Stroke Medicine: An Epidemiological and Pathophysiological Perspective

Alan King1, Karen M Doyle2

  • 1Department of Medicine, University of Limerick, Limerick, Ireland.

Current Vascular Pharmacology
|November 3, 2022
PubMed

Insights

Coronavirus 2019 (COVID-19) increases stroke risk, particularly ischemic stroke, due to inflammation. While COVID-19-related hemorrhagic stroke raises mortality, adenoviral vaccine-associated cerebral venous sinus thrombosis (CVST) risk is low and stroke rates are lower in vaccinated individuals.

Area of Science:

  • Vascular Neurology
  • Stroke Medicine
  • Infectious Diseases

Background:

  • Neurological complications of Coronavirus 2019 (COVID-19), including stroke, are increasingly documented.
  • COVID-19 is linked to a hypercoagulable state and inflammation, heightening the risk of both ischemic and hemorrhagic stroke, even in younger populations.
  • Hemorrhagic stroke in COVID-19 patients correlates with worse outcomes.

Approach:

  • This review synthesizes current evidence on COVID-19-related ischemic and hemorrhagic stroke.
  • It focuses on the epidemiology and inflammatory pathophysiology of stroke in the context of COVID-19.
  • The review also addresses cerebral venous sinus thrombosis (CVST) in relation to COVID-19 and adenoviral vaccines.

Key Points:

  • COVID-19 is associated with an elevated risk of ischemic stroke.
  • Hemorrhagic stroke in COVID-19 patients is linked to increased morbidity and mortality.
  • While adenoviral COVID-19 vaccines carry a small risk of cerebral venous sinus thrombosis (CVST), overall stroke prevalence appears lower in vaccinated versus unvaccinated COVID-19 patients.

Conclusions:

  • COVID-19 significantly impacts cerebrovascular health, increasing stroke incidence and severity.
  • Understanding the inflammatory mechanisms underlying COVID-19-related stroke is crucial for effective management.
  • Vaccination strategies may mitigate some stroke risks associated with COVID-19, despite rare vaccine-specific complications.

Keywords:
COVID-19Ischaemic strokecerebrovascular diseasehaemorrhagic strokehypercoagulable stateinflammation

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