COVID-19 Brain Injury
Conditions: Sars-CoV2; Severe Neurologic Injury; Ischemic Stroke; Hemorrhagic Stroke; Intracerebral Hemorrhage; Subarachnoid Hemorrhage; Traumatic Brain Injury; Status Epilepticus Intervention: Sponsor: University of Pittsburgh Active, not recruiting
Angelo Gemignani The Coronavirus Disease 2019 (COVID-19) outbreak has shocked the whole world with its unexpected rapid spread. The virus responsible for the disease, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), enters host cells by means of the envelope spike protein, which binds to angiotensin-converting enzyme 2 receptors. These receptors are highly expressed in heart, lungs, respiratory tract epithelium, endothelial cells and brain. Since an increasing body of significant evidence is highlighting a possible neuroinvasion related to SARS-CoV-2, a state of the art on the neurological complication...
Coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), usually presents as a respiratory illness. Neurological manifestations can be seen in 36.4% of patients.1 Patients with vascular risk factors (VRFs), including history of stroke, tend to have worse prognosis.2 COVID-19 triggers a robust inflammatory response which leads to hypercoagulability and thromboembolism.3 Reports of stroke in patients with COVID-19 are mostly limited to small case series or case reports of ischemic stroke (IS), though intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) have also been reported.
AbstractObjectivesThe OVID study will demonstrate whether prophylactic-dose enoxaparin improves survival and reduces hospitalizations in symptomatic ambulatory patients aged 50 or older diagnosed with COVID-19, a novel viral disease characterized by severe systemic, pulmonary, and vessel inflammation and coagulation activation.Trial designThe OVID study is conducted as a multicentre open-label superiority randomised controlled trial.ParticipantsInclusion Criteria1. Signed patient informed consent after being fully informed about the study ’s background.2. Patients aged 50 years or older with a positive test for SARS-...
ConclusionWe observed an overall low rate of imaging-confirmed hemorrhagic stroke among patients hospitalized with COVID-19. Most hemorrhages in patients with COVID-19 infection occurred in the setting of therapeutic anticoagulation and were associated with increased mortality. Further studies are needed to evaluate the safety and efficacy of therapeutic anticoagulation in patients with COVID-19.
We report an atypical deep cerebral vein thrombosis complicated with hemorrhagic venous infarction in a patient positive for SARS-CoV-2 with no risk factors for thrombosis.
We report a unique neurologic complication of COVID-19 in a patient who had extensive cerebral small-vessel ischemic lesions resembling cerebral vasculitis in a characteristic combined imaging pattern of ischemia, hemorrhage, and punctuate postcontrast enhancement. Also, a characteristic lower extremity skin rash was present in our patient. Our observation lends support to the increasingly suspected mechanism of "endotheliitis" associated with this novel coronavirus.
ConclusionsIt is feasible to perform PDT on intubated COVID-19 patients using the AerosolVE negative-pressure tent. This is a promising low-cost device to decrease risk to healthcare providers during AGPs.
ConclusionsThe COVID-19 pandemic was associated with a significant decrease in all-cause admission and admissions due to cardiovascular events in the emergency department. Regarding acute cerebrovascular events there was a numerical decrease but no significant difference.
Covid-19 has significant implications of hematologic systems, including lymphocytopenia, thrombocytopenia, ischemic or hemorrhagic stroke, pulmonary thromboembolism, and myocardial infarction [1,2]. Iwasaki et al. reported that the pathogen of Covid-19, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can induce immune dysfunction, inflammation, and antibody-dependent enhancement by activating host cells via the Fc γIIa receptor in the same way as SARS-CoV-1 .
CONCLUSIONS: Considering the possibility of neurological involvement in patients with SARS-CoV-2 infection can result in earlier diagnosis and treatment; otherwise permanent, irreversible sequelae and even death may follow. More comprehensive studies may indicate that until the end of the present pandemic, young adults with unexplained and unexpected stroke as well as patients with newly diagnosed Guillain-Barré syndrome should be tested for SARS-CoV-2 infection. PMID: 32698732 [PubMed - as supplied by publisher]