Clinical and pathogenetic features of cerebral stroke in patients with new corоnavirus infection (COVID-19)

Abstract

We studied the patients had the acute cerebrovascular events after the community acquired pneumonia evoked by new COVID-19 infection. The aim of our paper is improving the diagnosis and treatment of that condition. Materials and methods . We analyzed the stroke clinical features of 121 patient suffering from community acquired pneumonia induced by COVID-19 for the first time. Two groups were formed depending on the proved pulmonary damage. The main group included 69.4 % of patients (n=84) with diagnosis of new coronavirus disease plus stroke. Patients with ischemic and hemorrhage stroke in absence of SARS-CoV-2 signs were formed control group (30.6 %; n=37). We compared severity of the diseases and explored the biochemical characteristics in the both groups. Outcomes of severe cerebral and pulmonary injury were analyzed statistically. Results . Post-stroke patients with coronavirus disease showed predominantly the ischemic stroke (86.4 %) for unspecified (41.4 %) and cardioembolic (35.7%) pathogenetic subtypes (according to TOAST) with localization in the carotid basin (89.7 %). The hemorrhagic stroke more often was accompanied by parenchymal hemorrhage (54.5 %). The severity of the developed stroke according to the NIHSS scale is up to 13.16 (8.80) points with less severe brain damage Glasgow coma scale (14.0 (12.0 15.0). In the group of patients, widespread lung tissue damage was diagnosed in 82,2% of cases. The reliable increase of clinically relevant hypercoagulation signs was absent. Conclusions . Post-stroke patients with COVID-19 mainly have ischemic signs with unspecified and cardioembolic subtypes in absence of any sex and age features. The differences in disease severity are absent. The outcomes of diseases are mainly favorable. The high activity of inflammatory changes is clinically revealed.