COVID and stroke

Abstract

Coronavirus disease 2019 (COVID-19) is a severe acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). First detected in December 2019, the virus has since spread across the globe and has infected 768 million people and has led to over 7 million deaths worldwide. In addition to its classical presentation of upper respiratory tract symptoms, a growing body of evidence had found an association between COVID-19 and a variety of neurological disorders, including cerebrovascular disease. Physicians should be aware of the possibility of neurological deficits due to stroke as an initial presentation of COVID-19, which significantly contributes to morbidity and mortality seen in this population of patients, and this knowledge should prompt timely management to optimize treatment outcome. This thesis reviews the epidemiology, pathophysiology, and management of acute ischemic stroke associated with COVID-19. The risk of acute stroke is significantly increased in severe COVID-19 disease with higher severity and worse prognosis. SARS-CoV-2 may directly or indirectly play a role in stroke pathogenesis through several mechanisms. While management of stroke in COVID-19 patients follows the same treatment protocol as non-COVID patients, there are some special considerations to keep in mind while managing these patients. Further studies are needed to help to understand risk, manifestations, response to treatment strategies, and outcomes in stroke patients with COVID-19 infection.