COVID-19 and cerebrovascular stroke: a mini review

Abstract

The novel corona virus has shown accelerated effect on stroke and stroke care. Worlds stroke organization has reported a decline in stroke admission due to use of FAST tool and usage of thrombolysis and thrombectomy. FAST stands for F=facial weakness, A=arm weakness, S=slurred speech T=time to call 911 in USA, 120 in China, 999 in England, 112 in EU. In case of 911, 9=word nine (slurred speech), 1 one arm weakness, 1=one side facial weakness. It has a record that 72% of the confirmed stroke patients had speech disturbance, 62% had facial drooping, and 87% had arm weakness. The most appropriate way to diagnose stroke is motor dysfunction or slurred speech than facial drooping. Articles have been selected from Google scholar, PubMed, PubMed Central, Scopus, Web of Science, Medline, Embase, Scimago, and Publon. Studies on stroke from these articles has shown that speech disturbance has a worse outcome after stroke compared with individuals where speech is unaffected. The incidence of speech disturbance is as high as 84.4% in stroke patients, and a speech disturbance persists at discharge in 75.8% of patients who survived their stroke. Therefore, presence or absence of speech disturbance has predictive value for outcome of a stroke patient. D dimer is very important haematological marker to diagnose Disseminated intra vascular coagulation (DIC). Again, it is known that sepsis is a common cause of DIC. This biomarker is released when a fibrin blood clot undergo degradation. Tassiopoulos et al mentioned about anticoagulant administration according to D-dimer level can improve respiratory or kidney function in a COVID-19 patient.