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. 2023 Jun 10;85(7):3701-3708.
doi: 10.1097/MS9.0000000000000953. eCollection 2023 Jul.

Cerebrovascular disease in patients with COVID-19 infection: a case series from Lebanon

Zeinab El Mawla  1 , Ghaidaa El Saddik  2 , Maya Zeineddine  3 , Mahmoud Hassoun  4 , Taghrid El Hajj  5
Affiliations

Cerebrovascular disease in patients with COVID-19 infection: a case series from Lebanon

Zeinab El Mawla et al. Ann Med Surg (Lond). .

Abstract

COVID-19 has been associated with a variety of multi-organs complications, with an increasing proportion of patients presenting with neurologic manifestations. There is still an uncertainty in the relationship between stroke and COVID-19. Therefore, in this study, the authors report 18 cases of acute stroke occurring in the setting of COVID-19 infection, including 11 ischaemic strokes and 7 haemorrhagic strokes and identified in a Lebanese tertiary hospital. In this case series, patients with ischaemic and haemorrhagic stroke had elevated markers of inflammation and coagulation. Ischaemic stroke patients were treated with different regimens of anti-platelets, anticoagulants, and thrombolytic therapies. Death was the most common outcome observed and was associated with the severity of COVID-19 infection.

Keywords: Lebanon; covid-19; haemorrhagic; ischaemic; neurologic complications; stroke.

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Conflict of interest statement

The authors declare that they have no competing interests and the research is not funded by any funding agency.

Figures

Figure 1
Figure 1
Classification of ischaemic stroke according to TOAST* criteria (n=11). *TOAST Criteria = The TOAST (trial of ORG 10172 in acute stroke treatment) classification denotes five sub types of ischaemic stroke: large-artery atherosclerosis (embolus / thrombosis); cardioembolism (high-risk / medium-risk); small-vessel occlusion (lacune); stroke of other determined aetiology; stroke of undetermined aetiology. X-axis showed the percentage of patients with different types of ischaemic stroke.
Figure 2
Figure 2
Distribution of intracerebral haemorrhage (n=7). X-axis showed the percentage of patients with different types of haemorrhagic stroke. IP, intraparenchymal; IV, intraventricular; SAH, subarachnoid haemorrhage.
Figure 3
Figure 3
CT brain illustrating intraventricular bleeding with midline shift. CT, computed tomography.
Figure 4
Figure 4
CT chest illustrating diffuse bilateral ground-glass infiltrates with a crazy-paving appearance of lungs. CT, computed tomography.
Figure 5
Figure 5
CT brain illustrating acute massive bleeding in the left basal ganglia, brainstem with extension to the ventricles. CT, computed tomography.
See this image and copyright information in PMC

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