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      SARS-CoV-2 infection and acute ischemic stroke in Lombardy, Italy.

      Author(s): 1 , 2 , 3 , 4 , 5 , 6 , 7 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 4 , 4 , 15 , 3 , 4 , 4 , 4 , 4 , 4 , 8 , 8 , 9 , 10 , 2 , 5 , 3 , 3 , 5 , 5 , 16 , 6 , 7 , 6 , 7 , 16 , 16 , 16 , 11 , 12 , 13 , 17 , 5 , 5 , 6 , 7 , 3 , 15 , 4
      Publication date (Electronic):
      Journal: Journal of neurology
      Publisher: Springer Science and Business Media LLC
      Keywords: COVID-19, Risk factors, Stroke, Viral infection

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          Abstract

          To characterize patients with acute ischemic stroke related to SARS-CoV-2 infection and assess the classification performance of clinical and laboratory parameters in predicting in-hospital outcome of these patients.

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          Most cited references36

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          Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus–Infected Pneumonia in Wuhan, China

          Dawei Wang, Bo Hu, Fangfang Zhu … (2020)
          In December 2019, novel coronavirus (2019-nCoV)-infected pneumonia (NCIP) occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of affected patients is limited.
          Article 0 comments Cited 10869 times – based on 0 reviews     Review now
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            Extrapulmonary manifestations of COVID-19

            Aakriti Gupta, Mahesh Madhavan, Kartik Sehgal … (2020)
            Although COVID-19 is most well known for causing substantial respiratory pathology, it can also result in several extrapulmonary manifestations. These conditions include thrombotic complications, myocardial dysfunction and arrhythmia, acute coronary syndromes, acute kidney injury, gastrointestinal symptoms, hepatocellular injury, hyperglycemia and ketosis, neurologic illnesses, ocular symptoms, and dermatologic complications. Given that ACE2, the entry receptor for the causative coronavirus SARS-CoV-2, is expressed in multiple extrapulmonary tissues, direct viral tissue damage is a plausible mechanism of injury. In addition, endothelial damage and thromboinflammation, dysregulation of immune responses, and maladaptation of ACE2-related pathways might all contribute to these extrapulmonary manifestations of COVID-19. Here we review the extrapulmonary organ-specific pathophysiology, presentations and management considerations for patients with COVID-19 to aid clinicians and scientists in recognizing and monitoring the spectrum of manifestations, and in developing research priorities and therapeutic strategies for all organ systems involved.
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              COVID-19 and its implications for thrombosis and anticoagulation

              Jean M Connors, Jerrold Levy (2020)
              Severe acute respiratory syndrome coronavirus 2, coronavirus disease 2019 (COVID-19)-induced infection can be associated with a coagulopathy, findings consistent with infection-induced inflammatory changes as observed in patients with disseminated intravascular coagulopathy (DIC). The lack of prior immunity to COVID-19 has resulted in large numbers of infected patients across the globe and uncertainty regarding management of the complications that arise in the course of this viral illness. The lungs are the target organ for COVID-19; patients develop acute lung injury that can progress to respiratory failure, although multiorgan failure can also occur. The initial coagulopathy of COVID-19 presents with prominent elevation of D-dimer and fibrin/fibrinogen-degradation products, whereas abnormalities in prothrombin time, partial thromboplastin time, and platelet counts are relatively uncommon in initial presentations. Coagulation test screening, including the measurement of D-dimer and fibrinogen levels, is suggested. COVID-19–associated coagulopathy should be managed as it would be for any critically ill patient, following the established practice of using thromboembolic prophylaxis for critically ill hospitalized patients, and standard supportive care measures for those with sepsis-induced coagulopathy or DIC. Although D-dimer, sepsis physiology, and consumptive coagulopathy are indicators of mortality, current data do not suggest the use of full-intensity anticoagulation doses unless otherwise clinically indicated. Even though there is an associated coagulopathy with COVID-19, bleeding manifestations, even in those with DIC, have not been reported. If bleeding does occur, standard guidelines for the management of DIC and bleeding should be followed.
              Article 0 comments Cited 1206 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (iso-abbrev): J Neurol
                Title: Journal of neurology
                Publisher: Springer Science and Business Media LLC
                ISSN (Electronic): 1432-1459
                ISSN (Print): 0340-5354
                Publication date (Electronic): Jan 2022
                Volume: 269
                Issue: 1
                Affiliations
                [1 ] Department of Clinical and Experimental Sciences, University of Brescia, P.le Spedali Civili, 1, 25123, Brescia, Italy. ale_pezzini@hotmail.com.
                [2 ] Department of Brain and Behavioural Sciences, Statistics and Genomic Unit, University of Pavia, Pavia, Italy.
                [3 ] Department of Neurology and Stroke Unit, Carlo Poma Hospital, ASST Mantova, Mantova, Italy.
                [4 ] Department of Clinical and Experimental Sciences, University of Brescia, P.le Spedali Civili, 1, 25123, Brescia, Italy.
                [5 ] Neurology Unit, Istituti Ospitalieri, ASST Cremona, Cremona, Italy.
                [6 ] Department of Neurology, Ospedale San Gerardo, ASST Monza, Monza, Italy.
                [7 ] Department of Medicine and Surgery and Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy.
                [8 ] Vascular Neurology-Stroke Unit, Spedali Civili Hospital, ASST Spedali Civili, Brescia, Italy.
                [9 ] Neurology Unit, Ospedale Nuovo, ASST Ovest Milanese, Legnano, Italy.
                [10 ] Neurology Unit and Stroke Unit, Department of Neurosciences and Niguarda Neuro Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
                [11 ] Neurology Unit, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy.
                [12 ] Neurology Unit, Ospedale "A. Manzoni", ASST Lecco, Lecco, Italy.
                [13 ] Emergency Neurology and Stroke Unit, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
                [14 ] Department of Neuroradiology, Papa Giovanni XXIII Hospital, ASST Papa Giovanni XXIII, Bergamo, Italy.
                [15 ] Department of Neurology, Papa Giovanni XXIII Hospital, ASST Papa Giovanni XXIII, Bergamo, Italy.
                [16 ] Neurology Unit, Ospedale "Sant'Anna", ASST Lariana, Como, Italy.
                [17 ] Stroke Unit, IRCCS Fondazione "C. Mondino", Pavia, Italy.
                Article
                Publisher Item ID: 10.1007/s00415-021-10620-8
                DOI: 10.1007/s00415-021-10620-8
                PMC ID: 8142879
                PubMed ID: 34031747
                SO-VID: 3a1c5160-8ba3-40ad-b270-c1c3bf947c15
                Copyright © © 2021. The Author(s).
                History

                Keywords: COVID-19,Risk factors,Stroke,Viral infection
                Data availability:
                Keywords: COVID-19, Risk factors, Stroke, Viral infection

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