Intravenous Thrombolysis for Stroke in a COVID-19 Positive Filipino Patient, a Case Report

Abstract

The 2019 Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which was first reported in Wuhan, China last December 2019, has been declared an emergency by the World Health Organization but eventually progressed to become a Pandemic. To date, Coronavirus Disease 2019 (COVID-19) has affected at least 100,000 individuals worldwide, reaching thousands of mortalities (Zhou et al., 2020; World Health Organization, 2020). In the Philippines, the number of COVID-19 confirmed positive cases is over 636 and is expected to rise (Department of Health, 2020). Respiratory infections alongside their comorbidities can induce acute myocardial infarction and acute ischemic stroke (Warren-Gash et al., 2018) [3]. These may further bring challenges in the management and administration of Intravenous (IV) Alteplase in eligible patients. Currently, there are no case reports in the administration IV Altepase in ischemic stroke patients who are COVID-19 positive. We present a case of a 62-year old female who was admitted due to cough, colds and shortness of breath of 2 weeks duration and was tested to be COVD-19 positive. She suffered from an ischemic stroke while in the Medical Intensive Care Unit and was given Intravenous thrombolysis.

Keywords: COVID-19; Coronavirus; IV-RTPA; SARS-CoV-2; Stroke.

Fig. 1

(A) Plain cranial CT scan shows subtle hypodensity on the Left Corona radiata and Centrum Semiovale denoting acute infarction. (B) CT angiography shows atherosclerotic intracranial arteries with significant stenosis at the M1 segment of the MCA.

Fig. 2

Areas of ground glass densities with focal areas of consolidation predominantly in both perihilar and peripheral regions.