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Characteristics of ischaemic stroke associated with COVID-19
Open accessAbstract
Characteristics of ischaemic stroke associated with COVID-19Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with coagulopathy causing venous and arterial thrombosis. 1 2 Recent data from the pandemic epicentre in Wuhan, China, reported neurological complications in 36% of 214 patients with COVID-19; acute cerebrovascular disease (mainly ischaemic stroke) was more common among 88 patients with severe COVID-19 than those with nonsevere disease (5.7% vs 0.8%).3 However, the mechanisms, phenotype and optimal management of ischaemic stroke associated with COVID-19 remain uncertain.We describe the demographic, clinical, radiological and laboratory characteristics of six consecutive patients assessed between 1 st and 16 th April 2020 at the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK, with acute ischaemic stroke and COVID-19 (confirmed by reverse-transcriptase PCR (RT-PCR)) (table 1).All six patients had large vessel occlusion with markedly elevated D-dimer levels (≥1000μg/L).Three patients had multiterritory infarcts, two had concurrent venous thrombosis, and, in two, ischaemic strokes occurred despite therapeutic anticoagulation.
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“Multiple immunostaining studies reveal that ACE2 protein in the human brain is predominantly or exclusively expressed in vasculature (and specifically expressed within pericytes) (52, 53, 70), and many neurological symptoms associated with CoV-2 infection like stroke or altered consciousness are consistent with an underlying vasculopathy (71-76).”
From Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia (2020) · cites this paper as [76]
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Metadata
- Authors
- Beyrouti, R., Adams, M. E., Benjamin, L., Cohen, H., Farmer, S. F., Goh, Y. Y., Humphries, F., Jäger, H. R., Losseff, N. A., Perry, R. J., Shah, S., Simister, R. J., Turner, D., Chandratheva, A., & Werring, D. J.
- Affiliations
- University College London Hospitals NHS Foundation Trust (GB)
- University of Liverpool (GB)
- University College London (GB)
- Corresponding author
- Werring, David J
- ORCID
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 2020-04-30
- Volume
- 91
- Issue
- 8
- Pages
- 889-891
- ISSN
- 0022-3050 (ISSN-L)
- 1468-330X
- PMC
- PMC7231545
- OpenAlex
- W3022807497
- Cited by
- 711
- References
- 5
- Citations by year
- 2026: 3 · 2025: 14 · 2024: 32 · 2023: 40 · 2022: 117 · 2021: 253 · 2020: 250
- FWCI
- 71.40
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- 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, ischemic stroke, large vessel occlusion, D-dimer, coagulopathy, venous thrombosis, anticoagulation failure, neurological complications of COVID-19, stroke features
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Aged, Aged, 80 and over, Brain Ischemia, Female, Humans, Male, Middle Aged, Pneumonia, Viral, Coronavirus Infections, Stroke, Pandemics
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