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Clin Hemorheol Microcirc ; 77(3): 311-322, 2021.
Article in English | MEDLINE | ID: covidwho-1211798


The emerging coronavirus disease (COVID-19) swept the world, affecting more than 200 countries and territories. As of August 22, 2020, the pandemic infected more than 23,329,752 including 807,054 patients who have died. Although the main clinical features of the pandemic disease are respiratory, cerebrovascular comorbidities emerged as one of the leading causes of death associated with COVID-19. Different case reports have indicated that C-reactive protein (CRP) and D-dimer (pro-inflammatory biomarkers) were elevated in COVID-19 patients, which can significantly increase the risk of ischemic stroke. Available data on cerebrovascular complications in COVID-19 patients were collected and a meta-analysis was designed and carried out to evaluate the risk of severity and mortality associated with high levels of CRP and D-dimer levels in COVID-19 patients. In addition, we aimed to describe the overall event rate of pre-existing cerebrovascular disease in COVID-19 patients. In our analysis, 5,614 cases have been studied, out of these patients 164 cases have developed cerebrovascular comorbities. Cerebrovascular comorbidity increased the risk of disease severity (odd ratio = 4.4; 95% CI: 1.48 to 12.84) and mortality (odd ratio = 7.0; 95% CI: 2.56 to 18.99). Statistical analyses showed that CRP and D-dimer serum levels were elevated by six-folds in the severe cases of COVID-19 patients. This significant increase in these two proteins levels can serve as a vital indicator for COVID-19 patients who are at increased risk of severe COVID-19 cerebrovascular complications, such as stroke.

C-Reactive Protein/metabolism , COVID-19/blood , Cerebrovascular Disorders/blood , Cerebrovascular Disorders/virology , Fibrin Fibrinogen Degradation Products/metabolism , Biomarkers/blood , COVID-19/pathology , Comorbidity , Female , Humans , Male , Risk Factors , SARS-CoV-2/isolation & purification , Severity of Illness Index , Treatment Outcome
J Neurol ; 267(9): 2485-2489, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-378307


Coronavirus disease 2019 (COVID-19) has become a pandemic disease globally. While it mostly presents with respiratory symptoms, it has already been found that it could manifest with a series of neurological symptoms as well, either at presentation or during the course of the disease. Symptoms vary from non-specific such as headache or dizziness to more specific such as convulsions and cerebrovascular disease (CVD). This study aims to give an overview of the neurological manifestations of COVID-19 and discuss the potential pathogenetic mechanisms of central nervous system (CNS) involvement. Clinicians and especially internists, neurologists, and infectious disease specialists should be aware of these symptoms and able to recognize them early. Prompt diagnosis and immediate management of the neurological manifestations of the novel coronavirus will not only improve the prognosis of COVID-19 patients but will also prevent the dissemination of the disease due to misdiagnosed cases.

Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Nervous System Diseases/epidemiology , Nervous System Diseases/physiopathology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Brain Diseases/blood , Brain Diseases/epidemiology , Brain Diseases/physiopathology , COVID-19 , Cerebrovascular Disorders/blood , Cerebrovascular Disorders/epidemiology , Cerebrovascular Disorders/physiopathology , Coronavirus Infections/blood , Humans , Nervous System Diseases/blood , Pandemics , Pneumonia, Viral/blood , SARS-CoV-2