4.2 Article

Ischemic stroke associated with novel coronavirus 2019: a report of three cases

Journal

INTERNATIONAL JOURNAL OF NEUROSCIENCE
Volume 131, Issue 12, Pages 1243-1247

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/00207454.2020.1782902

Keywords

Ischemic stroke; novel coronavirus; COVID-19; case report

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This report describes three cases of ischemic stroke associated with COVID-19 infection, with severe symptoms and involvement of large cerebral arteries in all patients, suggesting a potential link between COVID-19 and ischemic stroke that requires further research.
Introduction:There is limited evidence about the neurological manifestations of COVID-19 in infected patients. In this report, we describe three patients with ischemic stroke associated with COVID-19 infection. Methods:We report 3 cases of adult patients with ischemic stroke and novel coronavirus 2019 infection. Case 1 is an 88-year-old female with acute left hemiplegia and right peripheral facial paresis that she had a fever along with stroke symptoms. Case 2 is an 85-year-old female with left hemiplegia and drowsiness who had a weakness, asthenia, and dry cough 3 days before appearing stroke signs. Case 3 is a 55-year-old male with acute Broca & apos;s aphasia and right hemiplegia who experience fever and respiratory problems 3 days after admission. Results:The clinical symptoms of infected patients with COVID-19 have been associated with severe symptoms of ischemic stroke. Two patients were admitted to the ICU. RT-PCR of the oropharyngeal sample was positive in three cases. All patients had the involvement of large cerebral arteries. Conclusion:The mechanism by which COVID-19 causes ischemic stroke is unknown but it is likely by production inflammatory cytokines or direct infection of cerebral arteries. Therefore, regarding the current situation of the COVID-19 pandemic, it is indispensable that the possible diagnosis of COVID-19 vasculopathy is considered in all ischemic strokes of unclear etiology.

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