Ischemic stroke in coronavirus disease 19 (COVID-19) positive patient: a case report

https://doi.org/10.19106/JMedSciSI005203202015

Rosa De Lima Renita Sanyasi(1*), Esdras Ardi Pramudita(2)

(1) Panti Rapih Hospital, Yogyakarta
(2) Panti Rapih Hospital, Yogyakarta
(*) Corresponding Author

Abstract


A new coronavirus disease called COVID-19 was declared by World Health Organization (WHO). The COVID-19 may complicated into many other conditions, including neurologic. One among this neurologic complication is stroke. This paper aimed to report a case of ischemic stroke in COVID-19 positive patient in Yogyakarta, Indonesia. A male patient, 42 years old, came to emergency department with weakness in his right arm for two days as his main complain. He also had face drop on the right side, cough, and shortness of breath. He had a history of hyperthyroid and type II diabetes mellitus. The brain CT Scan showed a lacunar infarct in the left lentiform nucleus. Patient had nasopharynx and oropharynx swab to be checked for the presence of COVID-19 and the result was positive.The pathophysiology of stroke in COVID-19 include the hyperactivation of inflammatory factors that causes a fatal inflammatory storm. It also cause a damage of coagulation system which causing the D-dimer and platelet abnormalities, hypercoagulability from critical illness and cardioembolism from virus-related cardiac injury. Moreover, COVID-19 may cause a direct role in viral infection in central nervous system. In conclusion, ischemic stroke can be present along with COVID-19.

 


Keywords


COVID-19; stroke; coronavirus; comorbid; neurologic;

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References

  1. World Health Organization. Rolling updates on coronavirus disease (COVID-19). [Cited 2020 April 14th]. Cite from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen.
  2. World Health Organization. WHO characterizes COVID-19 as a pandemic. [Cited 2020 April 14th]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen.
  3. Minister of Health of Republic of Indonesia. 2020. Pedoman Pencegahan Dan Pengendalian Coronavirus Disease (COVID-19). Jakarta: Ministry of Health of Republic Indonesia.
  4. Gugus Tugas Percepatan Penanganan COVID-19. [Cited 2020 April 14th]. Available from: https://www.covid19.go.id/.
  5. Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395(10229):1054-62. https://org.doi/10.1016/S0140-6736(20)30566-3
  6. Zhao H, Shen D, Zhou H, Liu J, Chen S. Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence?. Lancet Neurol 2020. https://org.doi/10.1016/S1474-4422(20)30109-5
  7. Mao L, Wang M, Chen S, He Q, Chang J, Hong C, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. JAMA Neurol 2020. https://doi.org/10.1101/2020.02.22.20026500.
  8. Poyiadji N, Shahin G, Noujaim D, Stone M, Patel S, Griffith B. COVID-19–associated acute hemorrhagic necrotizing encephalopathy: CT and MRI features. Radiology 2020. https://org.doi/10.1148/radiol.2020201187
  9. Chen R, Ovbiagele B, Feng W. Diabetes and stroke: epidemiology, pathophysiology, pharmaceuticals and outcomes. Am J Med Sci 2016; 351(4):380-6. https://org.doi/10.1016/j.amjms.2016.01.011
  10. Tanabe N, Hiraoka E, Hoshino M, Deshpande GA, Sawada K, Norisue Y, et al. Progressive ischemic stroke due to thyroid storm-associated cerebral venous thrombosis. Am J Case Rep 2017; 18: 194-7. https://org.doi/10.12659/ajcr.902297
  11. Jin H, Hong C, Chen S, Zhou Y, Wang Y, Mao L, et al. Consensus for prevention and management of coronavirus disease 2019 (COVID-19) for neurologists. Stroke Vasc Neurol 2020. https://org.doi/10.1136/svn-2020-000382
  12. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020. https://org.doi/10.1001/jamacardio.2020.1017
  13. Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may be at least partially responsible for the respiratory failure of COVID-19 patients. J Med Virol 2020. https://org.doi /10.1002/jmv.25728
  14. Burhan E, Isbaniah F, Susanto AD, Aditama TY, Soedarsono, Sartono TR, et al. Pneumonia COVID-19, diagnosis dan penatalaksanaan di Indonesia. Jakarta: Perhimpunan Dokter Paru Indonesia.
  15. Xu P, Zhou Q, Xu J. Mechanism of thrombocytopenia in COVID-19 patients. Ann Hematol 2020;15:1-4. https://org.doi/10.1007/s00277-020-04019-0
  16. Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan GB, et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol 2020; 95(6):E131–4. https://org.doi/10.1002/ajh.25774
  17. Liu Y, Sun W, Guo Y, Chen L, Zhang L, Zhao S, et al. Association between platelet parameters and mortality in coronavirus disease 2019: Retrospective cohort study. Platelets 2020.https://org.doi/10.1080/09537104.2020.1754383



DOI: https://doi.org/10.19106/JMedSciSI005203202015

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