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Missed cerebrovascular events during prolonged sedation for COVID-19 pneumonia.
Bruce, Samuel S; Kahan, Joshua; Huq, Tashfin; Santillan, Alejandro; Navi, Babak B; Merkler, Alexander E; Parikh, Neal S; Mir, Saad; Schweitzer, Andrew D; Segal, Alan Z.
  • Bruce SS; Clinical and Translational Neuroscience Unit, Brain and Mind Research Institute, and Department of Neurology, Weill Cornell Medical College, United States. Electronic address: sab7015@nyp.org.
  • Kahan J; Clinical and Translational Neuroscience Unit, Brain and Mind Research Institute, and Department of Neurology, Weill Cornell Medical College, United States.
  • Huq T; Clinical and Translational Neuroscience Unit, Brain and Mind Research Institute, and Department of Neurology, Weill Cornell Medical College, United States.
  • Santillan A; Clinical and Translational Neuroscience Unit, Brain and Mind Research Institute, and Department of Neurology, Weill Cornell Medical College, United States.
  • Navi BB; Clinical and Translational Neuroscience Unit, Brain and Mind Research Institute, and Department of Neurology, Weill Cornell Medical College, United States.
  • Merkler AE; Clinical and Translational Neuroscience Unit, Brain and Mind Research Institute, and Department of Neurology, Weill Cornell Medical College, United States.
  • Parikh NS; Clinical and Translational Neuroscience Unit, Brain and Mind Research Institute, and Department of Neurology, Weill Cornell Medical College, United States.
  • Mir S; Clinical and Translational Neuroscience Unit, Brain and Mind Research Institute, and Department of Neurology, Weill Cornell Medical College, United States.
  • Schweitzer AD; Department of Radiology, Division of Neuroradiology, Weill Cornell Medical College, United States.
  • Segal AZ; Clinical and Translational Neuroscience Unit, Brain and Mind Research Institute, and Department of Neurology, Weill Cornell Medical College, United States.
J Clin Neurosci ; 86: 180-183, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1032688
Semantic information from SemMedBD (by NLM)
1. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
2. Complication PROCESS_OF Patients
Subject
Complication
Predicate
PROCESS_OF
Object
Patients
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Deep Sedation TREATS Acute respiratory distress syndrome due to disease caused by Severe acute respiratory syndrome coronavirus 2
Subject
Deep Sedation
Predicate
TREATS
Object
Acute respiratory distress syndrome due to disease caused by Severe acute respiratory syndrome coronavirus 2
5. Ischemic stroke PROCESS_OF Patients
Subject
Ischemic stroke
Predicate
PROCESS_OF
Object
Patients
6. Toxic Epidermal Necrolysis PROCESS_OF Patients
Subject
Toxic Epidermal Necrolysis
Predicate
PROCESS_OF
Object
Patients
7. Critical Illness PROCESS_OF Patients
Subject
Critical Illness
Predicate
PROCESS_OF
Object
Patients
8. Complication PROCESS_OF Patients
Subject
Complication
Predicate
PROCESS_OF
Object
Patients
9. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
10. Deep Sedation TREATS Acute respiratory distress syndrome due to disease caused by Severe acute respiratory syndrome coronavirus 2
Subject
Deep Sedation
Predicate
TREATS
Object
Acute respiratory distress syndrome due to disease caused by Severe acute respiratory syndrome coronavirus 2
11. Ischemic stroke PROCESS_OF Patients
Subject
Ischemic stroke
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PROCESS_OF
Object
Patients
12. Toxic Epidermal Necrolysis PROCESS_OF Patients
Subject
Toxic Epidermal Necrolysis
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PROCESS_OF
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Patients
ABSTRACT
Cerebrovascular complications among critically ill patients with COVID-19 have yet to be fully characterized. In this retrospective case series from a single academic tertiary care referral center in New York City, we present 12 patients with ischemic or hemorrhagic strokes that were found on imaging after a period of prolonged sedation in the setting of COVID-19 pneumonia. This series demonstrates a pattern of cerebrovascular events clinically masked by deep sedation required for management of COVID-19 related acute respiratory distress syndrome (ARDS). Of the 12 patients included, 10 had ischemic stroke, 4 of which had hemorrhagic conversion, and 2 had primary intracerebral hemorrhage. Ten patients were on therapeutic anticoagulation prior to discovery of their stroke, and the remainder received intermediate dose anticoagulation (in a range between prophylactic and therapeutic levels). Additional studies are needed to further characterize the counterbalancing risks of ischemic and hemorrhagic stroke, as well as the optimal management of this patient population.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / Deep Sedation / COVID-19 Type of study: Observational study / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: J Clin Neurosci Journal subject: Neurology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Stroke / Deep Sedation / COVID-19 Type of study: Observational study / Risk factors Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: J Clin Neurosci Journal subject: Neurology Year: 2021 Document Type: Article