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Ischemic Stroke in Patients With Covid-19 Disease: A Report of 10 Cases From Iran Publisher Pubmed



Ahmadi Karvigh S1 ; Vahabizad F1 ; Banihashemi G1 ; Sahraian MA1, 2 ; Gheini MR1 ; Eslami M1 ; Marhamati H1 ; Mirhadi MS1
Authors
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Authors Affiliations
  1. 1. Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Science, Tehran, Iran

Source: Cerebrovascular Diseases Published:2021


Abstract

Ischemic stroke seems to be one of the most serious neurologic complications in patients with COVID-19 infection. Herein, we report a series of 10 ischemic stroke patients with concomitant COVID-19 disease. Out of 10, 8 had large infarcts (3 massive middle cerebral artery, 2 basilar artery, 2 posterior cerebral artery, and 1 internal carotid artery infarct territory). Two had cardiogenic embolic stroke due to atrial fibrillation. Almost half of our patients did not have a vascular risk factor. Nine did not have fever and were diagnosed with COVID-19 upon admission for stroke. Stroke occurred in the first week of respiratory symptoms with moderate pulmonary involvement. Most Patients did not have hypoxia and did not establish respiratory failure or acute respiratory distress syndrome. The blood pressures were low and hemorrhagic transformation did not occur even after antiplatelet or anticoagulant therapy. Patients had markedly increased levels of lactate dehydrogenase, C-reactive protein, and D-dimer. Three patients died. It seems that ischemic strokes in COVID-19 patients tend to occur as large infarct and can be seen in patients with mild to moderate pulmonary involvement. © 2020