Journal Article Review Epublish 17 citations
PubMed: 35207494 DOI: 10.3390/life12020207
Pathomechanisms and Treatment Implications for Stroke in COVID-19: A Review of the Literature.
Life (Basel) 12(2)
Authors: Brian Stamm, Deborah Huang, Regina Royan, Jessica Lee, Joshua Marquez, Masoom Desai
Affiliations
- Department of Neurology, School of Medicine, Northwestern University Feinberg, Chicago, IL 60611, USA.
- Department of Emergency Medicine, School of Medicine, Northwestern University Feinberg, Chicago, IL 60611, USA.
- Department of Neurology, School of Medicine, University of New Mexico, Albuquerque, NM 87144, USA.
Abstract
Stroke in patients with COVID-19 has received increasing attention throughout the global COVID-19 pandemic, perhaps due to the substantial disability and mortality that can result when the two conditions co-occur. We reviewed the existing literature and found that the proposed pathomechanism underlying COVID-19-associated ischemic stroke is broadly divided into the following three categories: vasculitis, endothelialitis, and endothelial dysfunction; hypercoagulable state; and cardioembolism secondary to cardiac dysfunction. There has been substantial debate as to whether there is a causal link between stroke and COVID-19. However, the distinct phenotype of COVID-19-associated strokes, with multivessel territory infarcts, higher proportion of large vessel occlusions, and cryptogenic stroke mechanism, that emerged in pooled analytic comparisons with non-COVID-19 strokes is compelling. Further, in this article, we review the various treatment approaches that have emerged as they relate to the proposed pathomechanisms. Finally, we briefly cover the logistical challenges, such as delays in treatment, faced by providers and health systems; the innovative approaches utilized, including the role of tele-stroke; and the future directions in COVID-19-associated stroke research and healthcare delivery.
MeSH
Stroke, Therapeutics, Cerebral Hemorrhage, Covid-19, Sars-Cov-2
Cited by
- Household income is associated with functional outcomes in a multi-institutional cohort of patients with ischemic stroke and COVID-19. J Stroke Cerebrovasc Dis, 2023
- Door-in-Door-out Times for Interhospital Transfer of Patients With Stroke. JAMA, 2023
- Multi-omic Profiling Reveals Early Immunological Indicators for Identifying COVID-19 Progressors. bioRxiv, 2023
- Ischemic Stroke in a SARS-CoV-2-Positive Octagenarian Without Cardiovascular Risk Factors: A Case Report. Cureus, 2022
- Stroke in the COVID-19 pandemic era. Postep Psychiatr Neurol, 2023
- Genetic Architecture of Ischaemic Strokes after COVID-19 Shows Similarities with Large Vessel Strokes. Int J Mol Sci, 2023