THE INCIDENCE OF ISCHEMIC STROKE IN PATIENTS WITH COVID - 19: A SYSTEMATIC REVIEW
Keywords:
Stroke, CVD, COVID-19, SARS-CoV-2 thrombosisAbstract
COVID-19 is a multisystem infection that mainly affects the respiratory system, but also causes systemic inflammation, endothelialitis and thrombosis. The consequences of this are multisystem dysfunction of all organs and systems. In this systematic review, we sought to evaluate the clinical course and outcomes in stroke patients as a complication of COVID-19. To do this, a search was carried out in the PubMed and Embase database for keywords - stroke, ONMC, COVID – 19, thrombosis, ischemia and CVZ. The aim was to identify the incidence of stroke and mortality from stroke in patients with COVID – 19. 146 articles were found on this topic, from April 2020 to March 2021. The meta-analysis included only those studies in which patients with a positive PCR result for SARS-CoV-2 and with a confirmed violation of cerebral circulation participated. Out of 146 studies, we selected 8 articles in which 3427 patients participated. Among patients with SARS-CoV-2, 17% were hospitalized with cerebrovascular diseases, 13% with ischemic, and 3% with hemorrhagic strokes. Compared with the uninfected or with the control group, patients with SARS-CoV-2 infection had a relatively increased risk of ischemic stroke (HR = 1.72, 95% CI = 1.56-1.89) The risks of intrahospital mortality from cerebrovascular diseases were much higher in SARS-CoV-2 infected compared to the control group (HR = 2.7, 95% CI = 1.02-5.79). SARS-CoV-2 seems to be associated with an increased risk of developing cerebrovascular diseases, in particular, with ischemic stroke. It may also be associated with an increased risk of mortality.
References
Gane SB, Kelly C, Hopkins C. Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome? Rhinology. 2020;58(3):299–301. doi: 10.4193/Rhin20.114.
Gupta A, Paliwal VK, Garg RK. Is COVID-19-related Guillain-Barré syndrome different? Brain Behav Immun. 2020;87:177–178. doi: 10.1016/j. bbi.2020.05.051.
Gandhi S., Srivastava A. K., Ray U., Tripathi P.P. Is the Collapse of the Respiratory Center in the Brain Responsible for Respiratory Breakdown in COVID-19 Patients? ACS Chem Neuro- sci. 2020;11(10):1379-1381. doi: 10.1021/ acschemneuro.0c00217
Zhou Z, Kang H, Li S, Zhao X. Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms. J Neurol. 2020;1–6. doi: 10.1007/s00415-020-09929-7.
McNamara D. COVID-19 Linked to Large Vessel Stroke in Young Adults/ April 24, 2020/ https://www.medscape.com/viewarticle/929345?src=wnl_edit_tpal&uac=296430PX&impID=2359734&faf=1JAMANeurol.doi:10.1001/jamaneurol.2020.1127 PublishedonlineApril10,2020.
Ling Mao, Mengdie Wang, Shanghai Chen et al. Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan, China: a retrospective case series study. medRxiv, 2020.02.22.2002650010.1101/2020.02.22.20026500 (accessed on 2020-02-28).]
Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;10:15. doi: 10.1001/jamaneurol.2020.1127.
Montalvan V, Lee J, Bueso T, De Toledo J, Rivas K. Neurological manifestations of COVID-19 and other coronavirus infections: a systematic review. In.Vol 194. Clinical Neurology and Neurosurgery: Elsevier B.V.; 2020:105921–105921.
AlexanderE. Merkler, Neal S. Parikh, Saad Mir, et al. Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza JAMA Neurol. 2020;77(11):1366-1372. doi:10.1001/jamaneurol.2020.2730
Yaghi S, Ishida K, Torres J, Grory BM, Raz E, Humbert K, et al. SARS2-CoV-2 and stroke in a New York healthcare system. Stroke. 2020 doi: 10.1161/strokeaha.120.030335
Benussi A, Pilotto A, Premi E, et al. Clinical characteristics and outcomes of inpatients with neurologic disease and COVID-19 in Brescia, Lombardy, Italy. Neurology. 2020 Aug 18;95(7):e910-e920. doi: 10.1212/WNL.0000000000009848. Epub 2020 May 22. PMID: 32444493.
Agarwal S, Scher E, Rossan-Raghunath N, et al. Acute stroke care in a New York City comprehensive stroke center during the COVID-19 pandemic. J Stroke Cerebrovasc Dis. 2020 Sep;29(9):105068. doi: 10.1016/j.jstrokecerebrovasdis.2020.105068. Epub 2020 Jun 20. PMID: 32807471; PMCID: PMC7305900.
Escalard S, Maïer B, Redjem H,et al. Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19: Experience From Paris. Stroke. 2020 Aug;51(8):2540-2543. doi: 10.1161/STROKEAHA.120.030574. Epub 2020 May 29. PMID: 32466736; PMCID: PMC7282400.
Padmanabhan N, Natarajan I, Gunston R, Raseta M, Roffe C. Impact of COVID-19 on stroke admissions, treatments, and outcomes at a comprehensive stroke centre in the United Kingdom. Neurol Sci. 2021 Jan;42(1):15-20. doi: 10.1007/s10072-020-04775-x. Epub 2020 Oct 6. PMID: 33021704; PMCID: PMC7537376.
Katz JM, Libman RB, Wang JJ,et al. Cerebrovascular Complications of COVID-19. Stroke. 2020 Sep;51(9):e227-e231. doi: 10.1161/STROKEAHA.120.031265. Epub 2020 Aug 6. PMID: 32757751; PMCID: PMC7467046.
Brunetti V, Broccolini A, Caliandro P, et al. Effect of the COVID-19 pandemic and the lockdown measures on the local stroke network. Neurol Sci. 2021 Apr;42(4):1237-1245. doi: 10.1007/s10072-021-05045-0. Epub 2021 Jan 15. PMID: 33452656; PMCID: PMC7810284
Montagnon R, Rouffilange L, Agard G, et al. Impact of the COVID-19 Pandemic on Emergency Department Use: Focus on Patients Requiring Urgent Revascularization. J Emerg Med. 2021 Feb;60(2):229-236. doi: 10.1016/j.jemermed.2020.09.042. Epub 2020 Oct 28. PMID: 33129611; PMCID: PMC7598350.
Trejo-Gabriel-Galan JM. Stroke as a complication and prognostic factor of COVID-19. Neurologia. 2020;35(5):318–322.
Siow I, Lee KS, Zhang JJY, Saffari SE, Ng A, Young B. Stroke as a Neurological Complication of COVID-19: A Systematic Review and Meta-Analysis of Incidence, Outcomes and Predictors. J Stroke Cerebrovasc Dis. 2021;30(3):105549. doi:10.1016/j.jstrokecerebrovasdis.2020.105549
Ashrafi F, Zali A, Ommi D. COVID-19-related strokes in adults below 55 years of age: a case series. Neurol Sci. 2020
Hess DC, Eldahshan W., Rutkowski E. Инсульт, связанный с COVID-19. Перевод Stroke Res. 2020; 11 (3): 322–325.
Zhang Y, Xiao M, Zhang S. Coagulopathy and antiphospholipid antibodies in patients with Covid-19. N Engl J Med. 2020;382(17):e38
Рахимбаева Гульнора Саттаровна, Шодиев Улуғбек Дониёр ўғли. Постковид цeрeбро-астeник синдром: диагностик йондашувларни оптималлаштириш, долзарб жихатлари // Журнал неврологии и нейрохирургических исследований №2.2021. 6-10 бет.
Туйчиев Л.Н., Рахимбаева Г.С., Газиева Ш.Р., Атаниязов М.К. Новая коронавирусная ин¬фекция и постковидные неврологиче¬ские последствия заболевания // Вестник ТМА № 2, 2021. 45-50 стр.
Атаниязов Махсуджан Камаладдинович, Рахимбаева Гульнора Саттаровна, Газиева Шохида Рустамовна. Характерные особенности инсульта при covid-19 // Журнал неврологии и нейрохирургических исследований №2.2021.14-17 стр.
