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Intravenous tPA for Acute Ischemic Stroke in Patients with COVID-19.
Carneiro, Thiago; Dashkoff, Jonathan; Leung, Lester Y; Nobleza, Christa O'Hana S; Marulanda-Londono, Erika; Hathidara, Mausaminben; Koch, Sebastian; Sur, Nicole; Boske, Alexandra; Voetsch, Barbara; Aboul Nour, Hassan; Miller, Daniel J; Daneshmand, Ali; Shulman, Julie; Curiale, Gioacchino; Greer, David M; Romero, Jose Rafael; Anand, Pria; Cervantes-Arslanian, Anna M.
Afiliación
  • Carneiro T; Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Collamore C3 Neurology, Boston, MA 02118, United States.
  • Dashkoff J; Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Collamore C3 Neurology, Boston, MA 02118, United States.
  • Leung LY; Department of Neurology, Stroke and Cerebrovascular Diseases Division, Tufts Medical Center, Boston, MA, United States.
  • Nobleza COS; Department of Neurology, Neuroscience Critical Care Division, University of Mississippi Medical Center, Jackson, MS, United States.
  • Marulanda-Londono E; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States.
  • Hathidara M; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States.
  • Koch S; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States.
  • Sur N; Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States.
  • Boske A; Department of Neurology, Saint David's Round Rock Medical Center, Round Rock, TX, United States.
  • Voetsch B; Department of Neurology, Lahey Hospital and Medical Center, Burlington, MA, United States.
  • Aboul Nour H; Department of Neurology, Henry Ford Hospital, Wayne State University, Detroit, MI, United States.
  • Miller DJ; Department of Neurology, Henry Ford Hospital, Wayne State University, Detroit, MI, United States.
  • Daneshmand A; Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Collamore C3 Neurology, Boston, MA 02118, United States.
  • Shulman J; Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Collamore C3 Neurology, Boston, MA 02118, United States.
  • Curiale G; Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Collamore C3 Neurology, Boston, MA 02118, United States.
  • Greer DM; Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Collamore C3 Neurology, Boston, MA 02118, United States.
  • Romero JR; Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Collamore C3 Neurology, Boston, MA 02118, United States; NHLBI's Framingham Heart Study, Framingham, MA, United States.
  • Anand P; Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Collamore C3 Neurology, Boston, MA 02118, United States. Electronic address: pria2@bu.edu.
  • Cervantes-Arslanian AM; Department of Neurology, Boston University School of Medicine, 72 East Concord Street, Collamore C3 Neurology, Boston, MA 02118, United States.
J Stroke Cerebrovasc Dis ; 29(11): 105201, 2020 Nov.
Article en En | MEDLINE | ID: mdl-33066885
BACKGROUND/PURPOSE: Coronavirus disease 2019 (COVID-19) is associated with increased risk of acute ischemic stroke (AIS), however, there is a paucity of data regarding outcomes after administration of intravenous tissue plasminogen activator (IV tPA) for stroke in patients with COVID-19. METHODS: We present a multicenter case series from 9 centers in the United States of patients with acute neurological deficits consistent with AIS and COVID-19 who were treated with IV tPA. RESULTS: We identified 13 patients (mean age 62 (±9.8) years, 9 (69.2%) male). All received IV tPA and 3 cases also underwent mechanical thrombectomy. All patients had systemic symptoms consistent with COVID-19 at the time of admission: fever (5 patients), cough (7 patients), and dyspnea (8 patients). The median admission NIH stroke scale (NIHSS) score was 14.5 (range 3-26) and most patients (61.5%) improved at follow up (median NIHSS score 7.5, range 0-25). No systemic or symptomatic intracranial hemorrhages were seen. Stroke mechanisms included cardioembolic (3 patients), large artery atherosclerosis (2 patients), small vessel disease (1 patient), embolic stroke of undetermined source (3 patients), and cryptogenic with incomplete investigation (1 patient). Three patients were determined to have transient ischemic attacks or aborted strokes. Two out of 12 (16.6%) patients had elevated fibrinogen levels on admission (mean 262.2 ± 87.5 mg/dl), and 7 out of 11 (63.6%) patients had an elevated D-dimer level (mean 4284.6 ±3368.9 ng/ml). CONCLUSIONS: IV tPA may be safe and efficacious in COVID-19, but larger studies are needed to validate these results.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía Viral / Terapia Trombolítica / Isquemia Encefálica / Activador de Tejido Plasminógeno / Infecciones por Coronavirus / Accidente Cerebrovascular / Fibrinolíticos Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neumonía Viral / Terapia Trombolítica / Isquemia Encefálica / Activador de Tejido Plasminógeno / Infecciones por Coronavirus / Accidente Cerebrovascular / Fibrinolíticos Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: J Stroke Cerebrovasc Dis Asunto de la revista: ANGIOLOGIA / CEREBRO Año: 2020 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos