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COVID-19 and ischemic stroke: a systematic review and meta-summary of the literature.
Tan, Ying-Kiat; Goh, Claire; Leow, Aloysius S T; Tambyah, Paul A; Ang, Alicia; Yap, Eng-Soo; Tu, Tian-Ming; Sharma, Vijay K; Yeo, Leonard L L; Chan, Bernard P L; Tan, Benjamin Y Q.
Afiliación
  • Tan YK; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, 119228, Singapore.
  • Goh C; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, 119228, Singapore.
  • Leow AST; Division of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.
  • Tambyah PA; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, 119228, Singapore.
  • Ang A; Division of Infectious Diseases, Department of Medicine, National University Health System, Singapore, Singapore.
  • Yap ES; Division of Infectious Diseases, Department of Medicine, National University Health System, Singapore, Singapore.
  • Tu TM; Department Laboratory Medicine, National University Hospital, Singapore, Singapore.
  • Sharma VK; Department of Haematology-Oncology, National University Cancer Institute, Singapore, Singapore.
  • Yeo LLL; Department of Neurology, National Neuroscience Institute, Singapore, Singapore.
  • Chan BPL; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, 119228, Singapore.
  • Tan BYQ; Division of Neurology, Department of Medicine, National University Health System, Singapore, Singapore.
J Thromb Thrombolysis ; 50(3): 587-595, 2020 Oct.
Article en En | MEDLINE | ID: mdl-32661757
Acute ischemic stroke (AIS) is a life-threatening complication of coronavirus disease 2019 (COVID-19) infection. Increasing reports suggest an association between COVID-19 and AIS, although the underlying mechanism remains uncertain. We performed a systematic review to characterize the clinical characteristics, neuroimaging findings, and outcomes of AIS in COVID-19 patients. A literature search was performed in PubMed and Embase using a suitable keyword search strategy from 1st December 2019 to 29th May 2020. All studies reporting AIS occurrence in COVID-19 patients were included. A total of 39 studies comprising 135 patients were studied. The pooled incidence of AIS in COVID-19 patients from observational studies was 1.2% (54/4466) with a mean age of 63.4 ± 13.1 years. The mean duration of AIS from COVID-19 symptoms onset was 10 ± 8 days, and the mean NIHSS score was 19 ± 8. Laboratory investigations revealed an elevated mean D-dimer (9.2 ± 14.8 mg/L) and fibrinogen (5.8 ± 2.0 g/L). Antiphospholipid antibodies were detected in a significant number of cases. The majority of AIS neuroimaging patterns observed was large vessel thrombosis, embolism or stenosis (62.1%, 64/103), followed by multiple vascular territory (26.2%, 27/103). A high mortality rate was reported (38.0%, 49/129). We report the pooled incidence of AIS in COVID-19 patients to be 1.2%, with a high mortality rate. Elevated D-dimer, fibrinogen and the presence of antiphospholipid antibodies appear to be prominent in COVID-19 patients with concomitant AIS, but further mechanistic studies are required to elucidate their role in pathogenesis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía Viral / Isquemia Encefálica / Infecciones por Coronavirus / Accidente Cerebrovascular / Betacoronavirus Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Thromb Thrombolysis Asunto de la revista: ANGIOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Países Bajos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía Viral / Isquemia Encefálica / Infecciones por Coronavirus / Accidente Cerebrovascular / Betacoronavirus Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies / Systematic_reviews Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Thromb Thrombolysis Asunto de la revista: ANGIOLOGIA Año: 2020 Tipo del documento: Article País de afiliación: Singapur Pais de publicación: Países Bajos