[SARS-CoV-2 infection and ischemic stroke]

Abstract

The new coronavirus SARS-CoV-2 is causing a huge impact on health, economy, and social dynamics. The world is facing an emerging viral disease for which no specific treatment is available, and many aspects of the clinical behavior of the disease are still unknown, which makes the diagnosis and management a big challenge. Various neurological manifestations have been described and associated with SARS-CoV-2 infection. Stroke occurs in up to 6% of all patients with COVID-19, a figure that becomes significant given the large number of patients diagnosed to date. The clinical characteristics, presentation, evolution, and prognosis of these patients seem to have peculiarities that have not been seen in previous forms of stroke. Every time younger patients are observed, without a medical history, without infectious symptoms, with serious neurological results that pose a challenging and difficult approach. This review synthesizes the information available on the clinical characteristics and the proposals for its management.

Keywords: Accidente cerebrovascular; COVID-19; Coronavirus; Enfermedades del sistema nervioso; Neurological manifestations; SARS virus; Stroke; Virus del SRAS.

Figura 1

Principales mecanismos de ACV en pacientes con COVID-19. A) Vía de entrada al SNC incluyendo células nerviosas ubicadas en diferentes partes del organismo, en el cerebro las zonas relacionadas son la corteza motora, cíngulo posterior, sustancia negra, ventrículos, giro temporal medial, bulbo olfatorio, médula ventrolateral, núcleo tracto solitario, núcleo dorsal motor. B) Diferentes mecanismos protrombóticos, proinflamatorios que llevan a la lesión vascular del ACV. Figura realizada en biorender.com. ACV = ataque cerebrovascular; NC = nervio craneal; SNC = sistema nervioso central.