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Thromboembolic disease in COVID-19 patients: A brief narrative review
AbstractCorona virus 2 (SARS-CoV2/ Severe Acute Respiratory Syndrome Corona Virus 2) infection has emerged as a global health crisis. Incidence of thromboembolic disease is reported to be high in SARS-CoV2 disease and is seen in a multitude of organ systems ranging from cutaneous thrombosis to pulmonary embolism, stroke or coronary thrombosis sometimes with catastrophic outcomes. Evidence points towards a key role of thromboembolism, hypercoagulability and over production of proinflammatory cytokines mimicking a “cytokine storm” which leads to multiorgan failure. This brief narrative review highlights the pathophysiolo...
Source: Journal of Intensive Care - September 13, 2020 Category: Intensive Care Source Type: research

Characteristics of a Diverse Cohort of Stroke Patients with SARS-CoV-2 and Outcome by Sex
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.
Source: Journal of Stroke and Cerebrovascular Diseases - September 10, 2020 Category: Neurology Authors: G. Trifan, F.D. Goldenberg, F.C. Caprio, J. Biller, M. Schneck, A. Khaja, T. Terna, J. Brorson, C. Lazaridis, Z. Bulwa, R. Alvarado-Dyer, F.G. Saleh-Velez, S. Prabhakaran, E.M. Liotta, A. Batra, N.J. Reish, S. Ruland, M. Teitcher, W. Taylor, P. De la Pena Source Type: research

The potential role of microvascular pathology in the neurological manifestations of coronavirus infection
We present the hypothesis that pre-existing vascular damage (due to aging, cardiovascular disease, diabetes, hypertension or other conditions) facilitates infiltration of the virus into the central nervous system (CNS), increasing neuro-inflammation and the likelihood o f neurological symptoms. We also discuss the role of a neuroinflammatory cytokine profile in both blood–brain barrier dysfunction and macrovascular disease (e.g. ischemic stroke and thromboembolism). Future studies are needed to better understand the involvement of the microvasculature in coronavi rus neuropathology, and to test the diagnostic potential o...
Source: Fluids and Barriers of the CNS - September 9, 2020 Category: Neuroscience Source Type: research

Intraluminal Carotid Artery Thrombus in COVID-19: Another Danger of Cytokine Storm? EXTRACRANIAL VASCULAR
We report a series of 6 patients with COVID-19 with acute ischemic stroke due to intraluminal carotid artery thrombus presenting during an 8-day period. Six patients were included (5 men) with a mean age of 65.8 years (range, 55–78 years). COVID-19 was diagnosed by detection of Severe Acute Respiratory Syndrome coronavirus 2 in 5 patients and was presumed due to typical clinical and imaging findings in 1 patient. All patients had vascular risk factors including diabetes (83%), hyperlipidemia (100%), and smoking (17%). Four patients presented with large infarcts with initial NIHSS scores of 24–30. During their h...
Source: American Journal of Neuroradiology - September 8, 2020 Category: Radiology Authors: Mohamud, A. Y., Griffith, B., Rehman, M., Miller, D., Chebl, A., Patel, S. C., Howell, B., Kole, M., Marin, H. Tags: EXTRACRANIAL VASCULAR Source Type: research

Malignant Cerebral Ischemia in A COVID-19 Infected Patient: Case Review and Histopathological Findings
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is responsible for an unprecedented worldwide pandemic that has severely impacted the United States. As the pandemic continues, a growing body of evidence suggests that infected patients may develop significant coagulopathy with resultant thromboembolic complications including deep vein thrombosis, pulmonary embolism, myocardial infarction, and ischemic stroke. However, this data is limited and comes from recent small case series and observational studies on stroke types, mechanisms, and outcomes.
Source: Journal of Stroke and Cerebrovascular Diseases - August 4, 2020 Category: Neurology Authors: Smit D. Patel, Ryan Kollar, Patrick Troy, Xianyuan Song, Mohammad Khaled, Augusto Parra, Mubashir Pervez Source Type: research

Heparin-induced thrombocytopenia and thrombosis in a patient with Covid-19
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 [3].
Source: Thrombosis Research - August 2, 2020 Category: Hematology Authors: Ching-Tai Huang, Shao-Yun Hsu, Ko-Wei Chang, Chung-Guei Huang, Cheng-Ta Yang, Ming-Huei Cheng Tags: Letter to the Editors-in-Chief Source Type: research

Author's response to Letter to the Editor: Anticoagulant approach in COVID-19 patients with cerebral venous thrombosis.
We thank the Journal and the authors for the opportunity to further elaborate on the issue of anticoagulation choice raised in Siang et al's letter to the editor1. We appreciate Siang et al. raising this topic as it acutely impacts management of care and is becoming increasingly relevant as the number of reported thrombotic events associated with SARS-CoV-2 continues to rise.
Source: Journal of Stroke and Cerebrovascular Diseases - July 30, 2020 Category: Neurology Authors: David E. Klein, Richard Libman, Claudia Kirsch, Rohan Arora Source Type: research

Care for Patients with Stroke During the COVID-19 Pandemic: Physical Therapy and Rehabilitation Suggestions for Preventing Secondary Stroke
Infection with the novel severe acute respiratory syndrome coronavirus 2 causes the development of the novel 2019 coronavirus disease (COVID-19) and associated clinical symptoms, which typically presents as an upper respiratory syndrome such as pneumonia. Growing evidence indicates an increased prevalence of neurological involvement (e.g., in the form of stroke) during virus infection. COVID-19 has been suggested to be more than a lung infection because it affects the vasculature of the lungs and other organs and increases the risk of thrombosis.
Source: Journal of Stroke and Cerebrovascular Diseases - July 21, 2020 Category: Neurology Authors: Chien-Chih Wang, Jian-Kang Chao, Mong-Lien Wang, Yi-Ping Yang, Chien-Shiu Chien, Wei-Yi Lai, Yi-Chiang Yang, Yu-Hui Chang, Chen-Liang Chou, Chung-Lan Kao Source Type: research

Antimalarial and cytotoxic drugs on COVID-19 and the cardiovascular burden: Literature review and lessons to be learned.
DISCUSSION: There is no convincing clinical evidence of chloroquine, hydroxychloroquine with or without azithromycin, and remdesivir use in COVID-19. As evidence of systemic inflammation is rapidly unfolding, there is a dire need to maximize our resources to find the best possible solutions to the current crisis while conclusive evidence from clinical trials emerges. PMID: 32691699 [PubMed - as supplied by publisher]
Source: Vascular - July 20, 2020 Category: Surgery Authors: Sultan S, Acharya Y Tags: Vascular Source Type: research

COVID-19 and Stroke: Casual or Causal Role?
We present a case of stroke in a 62-year-old COVID-19-positive patient, with multiple vascular risk factors. The patient arrived 1 h after onset of symptoms, was treated with recombinant tissue plasminogen activator (rtPA) with improvement of neurologic deficits, and later developed right foot arterial ischemia (recanalized by balloon catheter angioplasty) and left arm superficial venous thrombosis. A control computed tomography (CT) scan 7 days after onset showed hemorrhagic transformation of ischemic lesion without mass effect. However, respiratory and neurologic conditions improved so that the patient was discharged to ...
Source: Cerebrovascular Diseases - July 7, 2020 Category: Neurology Source Type: research

The Emerging Threat of (Micro)Thrombosis in COVID-19 and Its Therapeutic Implications.
Abstract The recent emergence of SARS-CoV-2 and the ensuing global pandemic has presented a health emergency of unprecedented magnitude. Recent clinical data has highlighted that COVID-19 is associated with a significant risk of thrombotic complications ranging from microvascular thrombosis, venous thromboembolic disease and stroke. Importantly, thrombotic complications are markers of severe COVID-19 and are associated with multi-organ failure and increased mortality. The evidence to date supports the concept that the thrombotic manifestations of severe COVID-19 is due to the ability of SARS-CoV-2 to invade endo¬...
Source: Circulation Research - June 25, 2020 Category: Cardiology Authors: McFadyen JD, Stevens H, Peter K Tags: Circ Res Source Type: research

Priapism in a patient with coronavirus disease 2019 (COVID-19)
Thromboembolic complications related to SARS-CoV-2 have been extensively reported. They include deep vein thrombosis, pulmonary embolism, ischemic stroke, and acute coronary syndrome. Penile thrombosis has not been reported as a thrombotic complication of SARS-CoV-2 infection with hypercoagulability.Here we describe a case of priapism as a thromboembolic complication in a patient with COVID-19 who recovered from acute respiratory distress syndrome (ARDS). We discuss the underlying pathophysiological mechanisms mainly related to an hypercoagulability state.
Source: The American Journal of Emergency Medicine - June 17, 2020 Category: Emergency Medicine Authors: Myriam Lamamri, Ala Chebbi, Jordan Mamane, Sofia Abbad, Milena Munuzzolini, Florence Sarfati, St éphane Legriel Tags: Case Report Source Type: research

Priapism in a patient with coronavirus disease 2019 (COVID-19): A case report
Thromboembolic complications related to SARS-CoV-2 have been extensively reported. They include deep vein thrombosis, pulmonary embolism, ischemic stroke, and acute coronary syndrome. Penile thrombosis has not been reported as a thrombotic complication of SARS-CoV-2 infection with hypercoagulability.Here we describe a case of priapism as a thromboembolic complication in a patient with COVID-19 who recovered from acute respiratory distress syndrome (ARDS). We discuss the underlying pathophysiological mechanisms mainly related to an hypercoagulability state.
Source: The American Journal of Emergency Medicine - June 16, 2020 Category: Emergency Medicine Authors: Myriam Lamamri, Ala Chebbi, Jordan Mamane, Sofia Abbad, Milena Munuzzolini, Florence Sarfati, St éphane Legriel Source Type: research

Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms
AbstractCoronavirus disease 2019 (COVID-19), a disease caused by the novel betacoronavirus (SARS-CoV-2), has become a global pandemic threat. The potential involvement of COVID-19 in central nervous system (CNS) has attracted considerable attention due to neurological manifestations presented throughout the disease process. In addition, SARS-CoV-2 is structurally similar to SARS-CoV, and both bind to the angiotensin-converting enzyme 2 (ACE2) receptor to enter human cells. Thus, cells expressing ACE2, such as neurons and glial cells may act as targets and are thus vulnerable to SARS-CoV-2 infection. Here, we have reviewed ...
Source: Journal of Neurology - May 25, 2020 Category: Neurology Source Type: research

COVID-19-Related Stroke
AbstractThe COVID-19 pandemic is associated with neurological symptoms and complications including stroke. There is hypercoagulability associated with COVID-19 that is likely a “sepsis-induced coagulopathy” and may predispose to stroke. The SARS-CoV-2 virus binds to angiotensin-converting enzyme 2 (ACE2) present on brain endothelial and smooth muscle cells. ACE2 is a key part of the renin angiotensin system (RAS) and a counterbalance to angiotensin-converting enzyme 1 (ACE1) and angiotensin II. Angiotensin II is proinflammatory, is vasoconstrictive, and promotes organ damage. Depletion of ACE2 by SARS-CoV-2 may tip the...
Source: Translational Stroke Research - May 6, 2020 Category: Neurology Source Type: research

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