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Cerebrovascular Disease in Patients with COVID-19: A Review of the Literature and Case Series.
Reddy, Sujan T; Garg, Tanu; Shah, Chintan; Nascimento, Fábio A; Imran, Rajeel; Kan, Peter; Bowry, Ritvij; Gonzales, Nicole; Barreto, Andrew; Kumar, Abhay; Volpi, John; Misra, Vivek; Chiu, David; Gadhia, Rajan; Savitz, Sean I.
  • Reddy ST; Department of Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Garg T; Institute for Stroke and Cerebrovascular Disease, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Shah C; Department of Neurology, Houston Methodist Neurological Institute, Houston, Texas, USA.
  • Nascimento FA; Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.
  • Imran R; Department of Neurology, Baylor College of Medicine, Houston, Texas, USA.
  • Kan P; Department of Neurology, Houston Methodist Neurological Institute, Houston, Texas, USA.
  • Bowry R; Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
  • Gonzales N; Institute for Stroke and Cerebrovascular Disease, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Barreto A; Department of Neurosurgery, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Kumar A; Department of Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Volpi J; Institute for Stroke and Cerebrovascular Disease, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Misra V; Department of Neurology, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Chiu D; Institute for Stroke and Cerebrovascular Disease, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Gadhia R; Department of Neurosurgery, University of Texas Health Science Center at Houston, Houston, Texas, USA.
  • Savitz SI; Department of Neurology, Houston Methodist Neurological Institute, Houston, Texas, USA.
Case Rep Neurol ; 12(2): 199-209, 2020.
Article in English | MEDLINE | ID: covidwho-638529
Semantic information from SemMedBD (by NLM)
1. Cerebrovascular Disorders PROCESS_OF Patients
Subject
Cerebrovascular Disorders
Predicate
PROCESS_OF
Object
Patients
2. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
3. Thrombophilia COEXISTS_WITH COVID-19
Subject
Thrombophilia
Predicate
COEXISTS_WITH
Object
COVID-19
4. Cerebrovascular Disorders COEXISTS_WITH COVID-19
Subject
Cerebrovascular Disorders
Predicate
COEXISTS_WITH
Object
COVID-19
5. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
6. Blood Coagulation Disorders MANIFESTATION_OF Cerebrovascular Disorders
Subject
Blood Coagulation Disorders
Predicate
MANIFESTATION_OF
Object
Cerebrovascular Disorders
7. Inflammation MANIFESTATION_OF Cerebrovascular Disorders
Subject
Inflammation
Predicate
MANIFESTATION_OF
Object
Cerebrovascular Disorders
8. Endothelial dysfunction MANIFESTATION_OF Cerebrovascular Disorders
Subject
Endothelial dysfunction
Predicate
MANIFESTATION_OF
Object
Cerebrovascular Disorders
9. Neurotropism MANIFESTATION_OF Cerebrovascular Disorders
Subject
Neurotropism
Predicate
MANIFESTATION_OF
Object
Cerebrovascular Disorders
10. Cerebral Hemorrhage PROCESS_OF Patients
Subject
Cerebral Hemorrhage
Predicate
PROCESS_OF
Object
Patients
11. Ischemic stroke PROCESS_OF Patients
Subject
Ischemic stroke
Predicate
PROCESS_OF
Object
Patients
12. Embolism NEG_PROCESS_OF Patients
Subject
Embolism
Predicate
NEG_PROCESS_OF
Object
Patients
13. Elevated inflammatory markers PROCESS_OF Patients
Subject
Elevated inflammatory markers
Predicate
PROCESS_OF
Object
Patients
14. Process CAUSES Cerebrovascular accident
Subject
Process
Predicate
CAUSES
Object
Cerebrovascular accident
15. Embolic stroke PROCESS_OF Patients
Subject
Embolic stroke
Predicate
PROCESS_OF
Object
Patients
16. Cerebrovascular Disorders PROCESS_OF Patients
Subject
Cerebrovascular Disorders
Predicate
PROCESS_OF
Object
Patients
17. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
18. Thrombophilia COEXISTS_WITH COVID-19
Subject
Thrombophilia
Predicate
COEXISTS_WITH
Object
COVID-19
19. Cerebrovascular Disorders COEXISTS_WITH COVID-19
Subject
Cerebrovascular Disorders
Predicate
COEXISTS_WITH
Object
COVID-19
20. Cerebrovascular accident PROCESS_OF Patients
Subject
Cerebrovascular accident
Predicate
PROCESS_OF
Object
Patients
21. Blood Coagulation Disorders MANIFESTATION_OF Cerebrovascular Disorders
Subject
Blood Coagulation Disorders
Predicate
MANIFESTATION_OF
Object
Cerebrovascular Disorders
22. Inflammation MANIFESTATION_OF Cerebrovascular Disorders
Subject
Inflammation
Predicate
MANIFESTATION_OF
Object
Cerebrovascular Disorders
23. Endothelial dysfunction MANIFESTATION_OF Cerebrovascular Disorders
Subject
Endothelial dysfunction
Predicate
MANIFESTATION_OF
Object
Cerebrovascular Disorders
24. Neurotropism MANIFESTATION_OF Cerebrovascular Disorders
Subject
Neurotropism
Predicate
MANIFESTATION_OF
Object
Cerebrovascular Disorders
25. Cerebral Hemorrhage PROCESS_OF Patients
Subject
Cerebral Hemorrhage
Predicate
PROCESS_OF
Object
Patients
26. Ischemic stroke PROCESS_OF Patients
Subject
Ischemic stroke
Predicate
PROCESS_OF
Object
Patients
27. Embolism NEG_PROCESS_OF Patients
Subject
Embolism
Predicate
NEG_PROCESS_OF
Object
Patients
28. Elevated inflammatory markers PROCESS_OF Patients
Subject
Elevated inflammatory markers
Predicate
PROCESS_OF
Object
Patients
29. Process CAUSES Cerebrovascular accident
Subject
Process
Predicate
CAUSES
Object
Cerebrovascular accident
30. Embolic stroke PROCESS_OF Patients
Subject
Embolic stroke
Predicate
PROCESS_OF
Object
Patients
ABSTRACT
COVID-19 has been associated with a hypercoagulable state causing cardiovascular and neurovascular complications. To further characterize cerebrovascular disease (CVD) in COVID-19, we review the current literature of published cases and additionally report the clinical presentation, laboratory and diagnostic testing results of 12 cases with COVID-19 infection and concurrent CVD from two academic medical centers in Houston, TX, USA, between March 1 and May 10, 2020. To date, there are 12 case studies reporting 47 cases of CVD in COVID-19. However, only 4 small case series have described the clinical and laboratory findings in patients with COVID-19 and concurrent stroke. Viral neurotropism, endothelial dysfunction, coagulopathy and inflammation are plausible proposed mechanisms of CVD in COVID-19 patients. In our case series of 12 patients, 10 patients had an ischemic stroke, of which 1 suffered hemorrhagic transformation and two had intracerebral hemorrhage. Etiology was determined to be embolic without a clear cause identified in 6 ischemic stroke patients, while the remaining had an identifiable source of stroke. The majority of the patients had elevated inflammatory markers such as D-dimer and interleukin-6. In patients with embolic stroke of unclear etiology, COVID-19 may have played a direct or indirect role in the processes that eventually led to the strokes while in the remaining cases, it is unclear if infection contributed partially or was an incidental finding.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: Case Rep Neurol Year: 2020 Document Type: Article Affiliation country: 000508958

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Prognostic study Language: English Journal: Case Rep Neurol Year: 2020 Document Type: Article Affiliation country: 000508958