Issue №4-98, 2020

Ischemic Rtroke as a Clinical Form and Pathogenetic Model in the Structure of Central Nervous System Lesions in COVID-19

^1,2 Voznyuk I.A., ³ Ilyina O.M., ² Kolomentsev S.V.

¹ Saint-Petersburg I.I. Dzhanelidze research institute of emergency medicine, Saint Petersburg, Russian Federation
² Kirov Military Medical Academy, Saint Petersburg, Russian Federation
³ Saint-Petersburg Martyr George City Hospital, Saint Petersburg, Russian Federation

ABSTRACT

Models of pathogenetic effects of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the new coronavirus infection2019 (COVID-19) on the brain indicate the possibility of both direct and indirect damage.Objective of the research. To study the features of the course of ischemic stroke in patients with COVID-19 disease.Methods. A retrospective analysis of 5 cases of acute ischaemic stroke in patients with COVID-19 who underwent inpatienttreatment in march – April 2020 in one of the multi-specialty hospitals in Saint Petersburg, which was re-designated toreceive patients with COVID-19 infection and has a primary vascular department.Results. Among 5 patients COVID-19 (3 men, 2 women; average age 76.8±12.0 years), 3 registered in-hospital ischemicstroke (IHS), 2 patients were hospitalized with suspected cerebral stroke by ambulance. In vivo, COVID-19 was diagnosedin 3 patients; in 2 cases, the SARS-COV-2 virus was detected in the sectional material. All patients had high comorbidity: ahistory of stroke and/or myocardial infarction; 3 patients had diabetes mellitus; 2 had atrial fibrillation. Patients with IHSat the time of stroke development received secondary prevention of vascular events. the severity of ischemic stroke was21.4±4.3 on the NIHSS scale. According to the TOAST classification, the stroke was atherothrombotic (n=2), cardioembolic(n=1) and unspecified subtypes (n=2). Adverse outcome was registered in all cases on 5–11 day of stroke development(the average life expectancy after a stroke = 7,4 days).Conclusion. Experience in treating patients with COVID-19 indicates the need for monitoring the coagulation systemand active prevention of thrombosis. Providing care to patients with ischemic stroke on the background of COVID-19is associated with additional organizational difficulties associated with the need to comply with strict anti-epidemicmeasures, which affect the intra-hospital logistics and quality of care.

KEYWORDS: new COVID-19 coronavirus infection, acute ischemic stroke, in-hospital ischemic stroke, hypercoagulation

For citation: Voznyuk I.A., Ilyina O.M., Kolomentsev S.V. Ischemic Stroke as a Clinical Form and Pathogenetic Model in the Structure of Сentral Nervous System Lesions in COVID-19. Bulletin of Rehabilitation Medicine. 2020; 4 (98): 90–98. https://doi.org/10.38025/2078-1962-2020-98-4-90-98

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This is an open article under the CC BY 4.0 license. Published by the National Medical Research Center for Rehabilitation and Balneology.