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

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COVID-19 presenting as stroke

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

DOI 10.1016/j.bbi.2020.04.077PMC PMC7187846

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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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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
ORCID: Avula, Akshay
Nalleballe, Krishna
Narula, Naureen
Toom, Sudhamshi
Glaser, Allison
Venue: Brain, Behavior, and Immunity
Publisher: Elsevier BV
Published: 2020-07
Volume: 87
Pages: 115-119
ISSN: 0889-1591 (ISSN-L)
DOI: 10.1016/j.bbi.2020.04.077
PMC: PMC7187846
OpenAlex: W3018857106
Cited by: 558
References: 23
Citations by year: 2026: 5 · 2025: 1 · 2024: 22 · 2023: 27 · 2022: 78 · 2021: 172 · 2020: 251
FWCI: 57.12
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Brain Behavior and Immunity (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
Health Sciences › Medicine › Clinical Neurology › 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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