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Large vessel stroke in six patients following SARS-CoV-2 infection: a retrospective case study series of acute thrombotic complications on stable underlying atherosclerotic disease.
Eur J Neurol. 2020 Aug 06 [Online ahead of print]EJ

Abstract

BACKGROUND AND PURPOSE

Ischaemic stroke has been described in association with COVID-19. Several pathophysiological mechanisms have been suggested, i.e. prothrombotic state, cardiac injury etc. It was sought to assess the potential association between ischaemic stroke associated with SARS-CoV-2 infection and underlying atherosclerotic lesions.

METHODS

A retrospective analysis of stroke related to large vessel occlusion was conducted amongst patients with SARS-CoV-2 infection and underlying mild atherosclerotic disease, between 19 March and 19 April 2020 in six different stroke centers in the Île-de France area, France.

RESULTS

The median age was 52 years, median body mass index was 29.5 kg/m2 . All patients displayed previous vascular risk factors such as high blood pressure, diabetes, dyslipidemia or body mass index > 25. The delay between the first respiratory symptoms of COVID-19 and stroke was 11.5 days. At baseline, all had tandem occlusions, i.e. intracerebral and extracerebral thrombus assessed with computed tomography or magnetic resonance imaging. Cases displayed a large thrombus in the cervical carotid artery with underlying mild non-stenosing atheroma, after an etiological workup based on angio-computed tomography or magnetic resonance imaging and/or cervical echography.

CONCLUSION

Our study should alert clinicians to scrutinize any new onset of ischaemic stroke during COVID-19 infection, mainly in patients with vascular risk factors or underlying atherosclerotic lesions.

Authors+Show Affiliations

Neurovascular Unit, Interventional Neuroradiology Department, Foch Hospital, Suresnes, France.Neurovascular Unit, Saint Denis Hospital, Paris, France.Neurovascular Unit, Bichat University Hospital, Paris, France.Neurovascular Unit, Bichat University Hospital, Paris, France.Neurovascular Unit, Interventional Neuroradiology Department, Kremlin-Bicetre University Hospital, Kremlin-Bicetre, France.Neurovascular Unit, Interventional Neuroradiology Department, Kremlin-Bicetre University Hospital, Kremlin-Bicetre, France.Neurovascular Unit, Interventional Neuroradiology Department, Foch Hospital, Suresnes, France.Neurovascular Unit, Interventional Neuroradiology Department, Lariboisiere University Hospital Paris, Paris, France.Neurovascular Unit, Interventional Neuroradiology Department, Lariboisiere University Hospital Paris, Paris, France.Neurovascular Unit, Interventional Neuroradiology Department, Foch Hospital, Suresnes, France.Interventional Neuroradiology Department Rothschild Fundation, Paris, France.Interventional Neuroradiology Department Rothschild Fundation, Paris, France.Interventional Neuroradiology Department Rothschild Fundation, Paris, France.Neurovascular Unit, Saint Denis Hospital, Paris, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32761999

Citation

Lapergue, B, et al. "Large Vessel Stroke in Six Patients Following SARS-CoV-2 Infection: a Retrospective Case Study Series of Acute Thrombotic Complications On Stable Underlying Atherosclerotic Disease." European Journal of Neurology, 2020.
Lapergue B, Lyoubi A, Meseguer E, et al. Large vessel stroke in six patients following SARS-CoV-2 infection: a retrospective case study series of acute thrombotic complications on stable underlying atherosclerotic disease. Eur J Neurol. 2020.
Lapergue, B., Lyoubi, A., Meseguer, E., Avram, I., Denier, C., Venditti, L., Consoli, A., Guedon, A., Houdart, E., Weisenburger-Lile, D., Piotin, M., Maier, B., Obadia, M., & Broucker, T. D. E. (2020). Large vessel stroke in six patients following SARS-CoV-2 infection: a retrospective case study series of acute thrombotic complications on stable underlying atherosclerotic disease. European Journal of Neurology. https://doi.org/10.1111/ene.14466
Lapergue B, et al. Large Vessel Stroke in Six Patients Following SARS-CoV-2 Infection: a Retrospective Case Study Series of Acute Thrombotic Complications On Stable Underlying Atherosclerotic Disease. Eur J Neurol. 2020 Aug 6; PubMed PMID: 32761999.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Large vessel stroke in six patients following SARS-CoV-2 infection: a retrospective case study series of acute thrombotic complications on stable underlying atherosclerotic disease. AU - Lapergue,B, AU - Lyoubi,A, AU - Meseguer,E, AU - Avram,I, AU - Denier,C, AU - Venditti,L, AU - Consoli,A, AU - Guedon,A, AU - Houdart,E, AU - Weisenburger-Lile,D, AU - Piotin,M, AU - Maier,B, AU - Obadia,M, AU - Broucker,T D E, Y1 - 2020/08/06/ PY - 2020/05/28/received PY - 2020/08/01/accepted PY - 2020/8/8/pubmed PY - 2020/8/8/medline PY - 2020/8/8/entrez KW - COVID KW - atherosclerotic disease KW - cardiovascular disease KW - intravascular clotting KW - ischaemic stroke KW - large vessel occlusion JF - European journal of neurology JO - Eur. J. Neurol. N2 - BACKGROUND AND PURPOSE: Ischaemic stroke has been described in association with COVID-19. Several pathophysiological mechanisms have been suggested, i.e. prothrombotic state, cardiac injury etc. It was sought to assess the potential association between ischaemic stroke associated with SARS-CoV-2 infection and underlying atherosclerotic lesions. METHODS: A retrospective analysis of stroke related to large vessel occlusion was conducted amongst patients with SARS-CoV-2 infection and underlying mild atherosclerotic disease, between 19 March and 19 April 2020 in six different stroke centers in the Île-de France area, France. RESULTS: The median age was 52 years, median body mass index was 29.5 kg/m2 . All patients displayed previous vascular risk factors such as high blood pressure, diabetes, dyslipidemia or body mass index > 25. The delay between the first respiratory symptoms of COVID-19 and stroke was 11.5 days. At baseline, all had tandem occlusions, i.e. intracerebral and extracerebral thrombus assessed with computed tomography or magnetic resonance imaging. Cases displayed a large thrombus in the cervical carotid artery with underlying mild non-stenosing atheroma, after an etiological workup based on angio-computed tomography or magnetic resonance imaging and/or cervical echography. CONCLUSION: Our study should alert clinicians to scrutinize any new onset of ischaemic stroke during COVID-19 infection, mainly in patients with vascular risk factors or underlying atherosclerotic lesions. SN - 1468-1331 UR - https://www.unboundmedicine.com/medline/citation/32761999/Large_vessel_stroke_in_six_patients_following_SARS-CoV-2_infection:_a_retrospective_case_study_series_of_acute_thrombotic_complications_on_stable_underlying_atherosclerotic_disease L2 - https://doi.org/10.1111/ene.14466 DB - PRIME DP - Unbound Medicine ER -
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