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COVID-19 presenting as stroke
Open accessAbstract
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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“Both intracerebral hemorrhage, against which the P2X7 receptor antagonist protects [124], and clots are responsible for the primary stroke in the brain [128].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [128]
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Acute Ischemic Stroke Associated with COVID-19
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Study of Factors Associated with COVID-19 Mortality in a Rural Tertiary Health Care Center
Teli, J. G., Reddy, S., Kamath, V., Jacob, M. J., Mohan, D., & Markanday, K. (2021) · APIK Journal of Internal Medicine · doi:10.4103/ajim.ajim_38_21 · Cited by 3
Analysis of neurology consultations in hospitalized patients with COVID-19
Ser, M. H., Tanrıverdi, U., Özkara, Ç., Saip, S., Aliş, C., Güleç, Z. E. K., Nezir, G., Kızılkılıç, E. K., Süzgün, M. A., Abbaszade, H., et al. (2022) · Acta Neurologica Belgica · doi:10.1007/s13760-021-01836-6 · Cited by 3
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Brain Biomarkers in Patients with COVID-19 and Neurological Manifestations: A Narrative Review
Tyagi, M., Kapoor, I., Mahajan, C., Gupta, N., & Prabhakar, H. (2022) · Journal of Neuroanaesthesiology and Critical Care · doi:10.1055/s-0042-1744395 · Cited by 3
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Martín, V., Calderón-Montero, A., Barquilla-García, A., Vitelli‐Storelli, F., Segura‐Fragoso, A., Olmo-Quintana, V., Serrano-Cumplido, A., & on behalf of the COVID-19 Group of the Spanish Society of Primary Care Physicians (SEMERGEN) (2021) · PLoS ONE · doi:10.1371/journal.pone.0260769 · Cited by 3
Fanning, J. P. (2022) · Springer eBooks · doi:10.1007/978-3-030-94992-1_9 · Cited by 3
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Ischaemic stroke associated with COVID-19 in dialysis patients
de Lorenzo, A., Espinel, L., Revilla, Á., Corbalán, T., Martins, J., Naya, M. T., & Cubas, A. (2021) · Nefrología (English Edition) · doi:10.1016/j.nefroe.2021.11.002 · Cited by 3
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COVID-19 Associated Stroke—A Single Centre ExperiencePreprint
Sundar, U., Karnik, N. D., Mukhopadhyay, A., Darole, P. A., Kolte, S., Bansal, A., Gokhale, Y. A., Asole, D., Joshi, A. R., Pednekar, S., et al. (2021) · medRxiv · doi:10.1101/2021.02.15.21249420 · Cited by 3
What can the neurological manifestations of COVID-19 tell us : a meta-analysisPreprint
He, Y., Bai, X., Zhu, T., Huang, J., & Zhang, H. (2021) · Research Square · doi:10.21203/rs.3.rs-284876/v1 · Cited by 3
Role of Imaging in Diagnosis and Management of COVID-19: Evidence-Based Approaches
Pezzutti, D. L., & Makary, M. S. (2024) · Advances in experimental medicine and biology · doi:10.1007/978-3-031-61939-7_13 · Cited by 2
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Neurological complications of Covid-19:
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Timing of Acute Stroke in COVID-19—A Health System Registry Study
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Adapting patient treatment of neurological diseases during the COVID-19 pandemic
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Mahali, M., & Coolidge, F. L. (2023) · Brain Behavior & Immunity - Health · doi:10.1016/j.bbih.2023.100632 · Cited by 2
de Jesus, J. R. B., Martins‐Filho, P. R., Mota, A. F. D. B., Santos, C. S., Santos, J. M., Souza, F. O., Guedes-Granzotti, R. B., Júnior, M. B. G., & da Silva, K. (2023) · Critical Care Science · doi:10.5935/2965-2774.20230357-en · Cited by 2
Neuropathogenesis of SARS-CoV-2 in human neuronal, microglial and glial cells
Kumar, N., Santhoshkumar, R., Agrawal, R., Singh, A., Kalyan, V., Desai, A. S., Ravi, V., & Venkataswamy, M. M. (2024) · Archives of Microbiology · doi:10.1007/s00203-024-04075-4 · Cited by 2
COVID-19 Crisis: A Neurological Disorder Point of View
Muhammad, F. (2021) · The Open Neurology Journal · doi:10.2174/1874205x02115010001 · Cited by 2
Metadata
- 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)
- 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
- 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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