Cited by 558Long-Term Effects of COVID-19COVID-19 Clinical Research StudiesAcute Ischemic Stroke Management

COVID-19 presenting as stroke

Open access
Avula, Akshay, Nalleballe, Krishna, Narula, Naureen, Sapozhnikov, Steven, Dandu, Vasuki, Toom, Sudhamshi, Glaser, Allison, Elsayegh, Dany·2020·Brain, Behavior, and Immunity

Abstract

Objective Acute stroke remains a medical emergency even during the COVID-19 pandemic. Most patients with COVID-19 infection present with constitutional and respiratory symptoms; while others present with atypical gastrointestinal, cardiovascular, or neurological manifestations. Here we present a series of four patients with COVID-19 that presented with acute stroke.Methods We searched the hospital databases for patients that presented with acute stroke and concomitant features of suspected COVID-19 infection. All patients who had radiographic evidence of stroke and PCR-confirmed COVID-19 infection were included in the study. Patients admitted to the hospital with PCR- confirmed COVID-19 disease whose hospital course was complicated with acute stroke while inpatient were excluded from the study. Retrospective patient data were obtained from electronic medical records. Informed consent was obtained.Results We identified four patients who presented with radiographic confirmation of acute stroke and PCR-confirmed SARS-CoV-2 infection. We elucidate the clinical characteristics, imaging findings, and the clinical course.Conclusions Timely assessment and hyperacute treatment is the key to minimize mortality and morbidity of patients with acute stroke. Stroke teams should be wary of the fact that COVID-19 patients can present with cerebrovascular accidents and should dawn appropriate personal protective equipment in every suspected patient. Further studies are urgently needed to improve current understandings of neurological pathology in the setting of COVID-19 infection.

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Crossref · 10.1016/j.bbi.2020.04.077

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  • Both intracerebral hemorrhage and clots are responsible for the primary stroke in the brain.

    “Both intracerebral hemorrhage, against which the P2X7 receptor antagonist protects [124], and clots are responsible for the primary stroke in the brain [128].”

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Authors
Avula, A., Nalleballe, K., Narula, N., Sapozhnikov, S., Dandu, V., Toom, S., Glaser, A., & Elsayegh, D.
Affiliations
  • Northwell Health (US)
  • University of Arkansas for Medical Sciences (US)
  • Maimonides Medical Center (US)
Corresponding author
Avula, Akshay
Venue
Brain, Behavior, and Immunity
Publisher
Elsevier BV
Published
2020-07
Volume
87
Pages
115-119
ISSN
0889-1591 (ISSN-L)
OpenAlex
W3018857106
Cited by
558
References
23
Citations by year
2026: 5 · 2025: 1 · 2024: 22 · 2023: 27 · 2022: 78 · 2021: 172 · 2020: 251 · 2019: 1
FWCI
57.12
Type
journal article
Language
en
Open access
Locations
  • Brain Behavior and Immunity (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
  • Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
  • Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
Keywords
COVID-19 pandemic, SARS-CoV-2, acute stroke, stroke, atypical presentation, neurological symptoms, personal protective equipment, stroke team
MeSH terms
Betacoronavirus, COVID-19, SARS-CoV-2, Aged, Aged, 80 and over, Female, Hospitalization, Humans, Male, Pneumonia, Viral, Retrospective Studies, Coronavirus Infections, Stroke, Pandemics

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