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Characteristics of ischaemic stroke associated with COVID-19

Rahma BeyroutiComprehensive Stroke Service, University College London Hospitals NHS Foundation Trust, London, London, UKMatthew AdamsUniversity College LondonLaura BenjaminBrain Infections Group, Institute of Infection and Global Health, University of Liverpool, Liverpool, UKHannah CohenHemostasis Research Unit, Department of Hematology, University College London, London, UKSimon F. FarmerDepartment of Neurology, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, London, UKYee Yen GohNational Hospital for Neurology and NeurosurgeryFiona HumphriesComprehensive Stroke Service, University College London Hospitals NHS Foundation Trust, London, London, UKHans Rolf JägerLysholm Department of Neuroradiology, University College London Hospitals NHS Foundation Trust National Hospital for Neurology and Neurosurgery, London, London, UKNicholas LosseffUniversity College LondonRichard PerryComprehensive Stroke Service, University College London Hospitals NHS Foundation Trust, London, London, UKSachit ShahUniversity College LondonRobert SimisterUniversity College LondonDavid D. TurnerComprehensive Stroke Service, University College London Hospitals NHS Foundation Trust, London, London, UKArvind ChandrathevaStroke Research Centre, UCL Queen Square Institute of Neurology, London, UKDavid J. WerringStroke Research Centre, UCL Queen Square Institute of Neurology, London, UK

2020en

ABI

Annotatsiya

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with coagulopathy causing venous and arterial thrombosis. 1 2 Recent data from the pandemic epicentre in Wuhan, China, reported neurological complications in 36% of 214 patients with COVID-19; acute cerebrovascular disease (mainly ischaemic stroke) was more common among 88 patients with severe COVID-19 than those with nonsevere disease (5.7% vs 0.8%). However, the mechanisms, phenotype and optimal management of ischaemic stroke associated with COVID-19 remain uncertain. We describe the demographic, clinical, radiological and laboratory characteristics of six consecutive patients assessed between 1 st and 16 th April 2020 at the National Hospital for Neurology and Neurosurgery, Queen Square, London, UK, with acute ischaemic stroke and COVID-19 (confirmed by reverse-transcriptase PCR (RT-PCR)) (table 1). All six patients had large vessel occlusion with markedly elevated D-dimer levels (1000g/L). Three patients had multiterritory infarcts, two had concurrent venous thrombosis, and, in two, ischaemic strokes occurred despite therapeutic anticoagulation.

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DOI: 10.1136/jnnp-2020-323586

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