Coronavirus disease 2019 (COVID-19) related stroke incidence: a case series

https://doi.org/10.19106/JMedSci005503202307

Hanindia Riani Prabaningtyas(1*), Maria Yosita Ayu Hapsari(2), Stefanus Erdana Putra(3), Muhammad Hafizhan(4), Diah Kurnia Mirawati(5), Pepi Budianto(6), Subandi Subandi(7), Rivan Danuaji(8)

(1) Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta,
(2) Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta,
(3) Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta,
(4) Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta,
(5) Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta,
(6) Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta,
(7) Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta,
(8) Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret, Surakarta,
(*) Corresponding Author

Abstract


Coronavirus disease 2019 (COVID-19) can cause systemic and respiratory symptoms. Acute respiratory distress syndrome (ARDS), anemia, acute heart injury, secondary infection, and stroke are the complications of COVID-19. Age, oxidative stress, endothelial dysfunction, inflammatory status, vascular risk factors, and hypoxemia are risk factors for stroke associated with COVID-19. In this case report, two cases of COVID-19 complicated by stroke and other thromboembolic diseases were discussed. Case 1: a 46-year-old man presented with right extremities weakness, dysarthria, cough, colds, chest pain radiating to left upper extremity. He was diagnosed with moderate COVID-19, with complication of embolic stroke and myocardial infarction. After administration of IV furosemid and recombinant tissue plasminogen activator (rTPA), his condition improved, and he was discharged from our facility. Case 2: a 54-year-old woman presented with a decreased level of consciousness, skin discoloration, tenderness on her left calf, cough, fever, and shortness of breath. She was diagnosed with moderate COVID-19 with a complication of thrombotic stoke and deep vein thrombosis (DVT). She was treated with rTPA, IV citicoline, and fondaparinux for 5 days. In conclusion, COVID-19 carries a risk of thromboembolic complication. COVID-19 patients have a higher risk of bleeding, therefore, medications, particularly anticoagulant, should be administered with more caution.


Keywords


COVID-19; stroke; SARS-CoV-2; risk factors; thromboembolic

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DOI: https://doi.org/10.19106/JMedSci005503202307

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Copyright (c) 2023 Hanindia Riani Prabaningtyas, Maria Yosita Ayu Hapsari, Stefanus Erdana Putra, Muhammad Hafizhan, Diah Kurnia Mirawati, Pepi Budianto, Subandi Subandi, Rivan Danuaji

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