RT Journal Article
SR Electronic
T1 Characteristics of Large-Vessel Occlusion Associated with COVID-19 and Ischemic Stroke
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 2263
OP 2268
DO 10.3174/ajnr.A6799
VO 41
IS 12
A1 John, S.
A1 Kesav, P.
A1 Mifsud, V.A.
A1 Piechowski-Jozwiak, B.
A1 Dibu, J.
A1 Bayrlee, A.
A1 Elkambergy, H.
A1 Roser, F.
A1 Elhammady, M.S.
A1 Zahra, K.
A1 Hussain, S.I.
YR 2020
UL http://www.ajnr.org/content/41/12/2263.abstract
AB SUMMARY: The mechanisms and phenotype of ischemic stroke associated with coronavirus disease 2019 (COVID-19) remain uncertain. A retrospective study was conducted in patients with COVID-19 presenting with ischemic stroke from March 1 to May 25, 2020, and cases with large-vessel occlusion were identified. To provide baseline institutional stroke data within and outside the COVID-19 pandemic, all consecutive ischemic stroke and TIA admissions (COVID and non-COVID) to the hospital during a 10-week period from March 1 to May 10, 2020, were collected and compared with data from the same time period in 2019. Among 20 patients with COVID-19 and acute ischemic stroke, 15 (75%) had large-vessel occlusion. These patients were young (mean age, 46.5 years), male (93%), without major burden of traditional cardiovascular risk factors, and had a severe stroke presentation. Large-vessel occlusions were observed in multiple vessels (40%), uncommonly affected vessels, and atypical locations with a large thrombus burden. Systemic thrombosis separate from large-vessel occlusion was not uncommon (26%). At short-term follow-up, stroke etiology remained undetermined in 46% of patients and functional outcome was poor. The above findings raise the possibility of stroke related to mechanisms induced by the COVID-19 infection itself, including a hypercoagulable state and/or endothelial damage. In addition, they document the severe presentation and poor outcomes of large-vessel occlusion in COVID-19 ischemic stroke.CCAcommon carotid arteryCOVID-19coronavirus disease 2019LVOlarge-vessel occlusionSARS CoV-2Severe Acute Respiratory Syndrome coronavirus-2