Ischemic stroke associated with novel coronavirus 2019: a report of three cases

Abstract

Introduction

There is limited evidence about the neurological manifestations of COVID-19 in infected patients. In this report, we describe three patients with ischemic stroke associated with COVID-19 infection.

Methods

We report 3 cases of adult patients with ischemic stroke and novel coronavirus 2019 infection. Case 1 is an 88-year-old female with acute left hemiplegia and right peripheral facial paresis that she had a fever along with stroke symptoms. Case 2 is an 85-year-old female with left hemiplegia and drowsiness who had a weakness, asthenia, and dry cough 3 days before appearing stroke signs. Case 3 is a 55-year-old male with acute Brocaʼs aphasia and right hemiplegia who experience fever and respiratory problems 3 days after admission.

Results

The clinical symptoms of infected patients with COVID-19 have been associated with severe symptoms of ischemic stroke. Two patients were admitted to the ICU. RT-PCR of the oropharyngeal sample was positive in three cases. All patients had the involvement of large cerebral arteries.

Conclusion

The mechanism by which COVID-19 causes ischemic stroke is unknown but it is likely by production inflammatory cytokines or direct infection of cerebral arteries. Therefore, regarding the current situation of the COVID-19 pandemic, it is indispensable that the possible diagnosis of COVID-19 vasculopathy is considered in all ischemic strokes of unclear etiology.

Keywords:

• Ischemic stroke
• novel coronavirus
• COVID-19
• case report

Acknowledgement

The authors request to thank all the patients for their consent to publish the case report and the Research Vice-Chancellor of Mazandaran University of Medical Sciences for their supports.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.