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Published on: May 22, 2019
[Clinical and pathophysiological features of stroke in patients with COVID-19]
A A Rubakova1, J I Lebedeva2, E F Turovina2
1Federal Center for Cerebrovascular Pathology and Stroke, Moscow, Russia.
Insights
New coronavirus infection (COVID-19) is linked to increased stroke risk, often appearing 10-14 days after infection. This review examines the clinical and pathophysiological features of COVID-19-associated stroke.
Area of Science:
- Neurology
- Infectious Diseases
- Pathophysiology
Context:
- The novel coronavirus (SARS-CoV-2) has been associated with a wide range of clinical manifestations, including neurological complications.
- Stroke is a recognized, albeit less common, complication of COVID-19.
- Understanding the specific risks and mechanisms of stroke in COVID-19 patients is crucial for clinical management.
Purpose:
- To review the current literature on the clinical and pathophysiological characteristics of stroke in patients with COVID-19.
- To identify risk factors, clinical presentation, laboratory findings, and outcomes associated with COVID-19-related stroke.
- To explore potential pathogenetic mechanisms linking SARS-CoV-2 infection to cerebrovascular events.
Summary:
- Patients with COVID-19 exhibit numerous stroke risk factors, suggesting the infection may act as a trigger.
- Stroke typically manifests 10-14 days post-COVID-19 onset, often involving large vessel occlusions and multiple lesions.
- Key laboratory findings include coagulopathy, antiphospholipid antibodies, and impaired liver/kidney function, leading to high mortality (>70%) and poor outcomes.
Impact:
- COVID-19 can precipitate various neurological conditions, including stroke.
- Further research into the neuropathogenesis of COVID-19 and SARS-CoV-2's impact on disease progression is warranted.
- This review highlights the significant cerebrovascular risks associated with COVID-19, emphasizing the need for vigilance and further investigation.
Objective:
To study of modern literature on the clinical and pathophysiological features of stroke in patients with a new coronavirus infection (COVID-19).
Material And Methods:
Published data were searched in the electronic databases Medline (PubMed) and eLIBRARY for the period 2019-2022.
Results:
It has been shown that patients with COVID-19 have a large number of risk factors for stroke, which may indicate that COVID-19 is a trigger for the development of the disease. Stroke predominantly occurs in 10-14 days after the onset of COVID-19, i.e. there was a delayed manifestation. Patients with stroke due to a COVID-19 are characterized by occlusion of large vessels or vessels, in which occlusion occurs extremely rarely, as well as the presence of several lesions. Specific laboratory signs are coagulopathy, the presence of antiphospholipid antibodies, as well as impaired liver and kidney function. This cohort of patients is characterized by high mortality and poor functional outcome (in more than 70% of cases). The pathogenetic mechanism underlying stroke has not been established yet, however, in patients with COVID-19, the activation of a cascade of blood coagulation and thrombosis reactions is recorded. Suppression of ACE2 due to the affinity of its receptors for the COVID-19 virus probably also plays a role in the pathogenesis of stroke, since when the virus enters the body, an imbalance of the renin-angiotensin system develops.
Conclusion:
COVID-19 can lead to the development of various neurological diseases, including stroke. Further researches are needed to study neuropathogenesis of COVID-19 and the impact of virus SARS-CoV-2 on disease progression.
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