How is ischemic stroke linked to a COVID-19-infected patient different from other cardiovascular risk factors? a case report

COVID-19感染患者发生缺血性卒中与其他心血管危险因素有何不同?病例报告

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Abstract

Ischemic stroke is a recognized neurological consequence of an acute coronavirus disease 2019 (COVID-19) infection. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) directly infects endothelial cells, generating widespread endothelial inflammation. This may be the mechanism leading to an ischemic stroke. Infection with SARS-CoV-2 and inflammatory responses cause vascular damage, hypercoagulability, thrombin activation, platelet aggregation, and plaque shedding as a result of hemodynamic alterations, which increase the risk of ischemic stroke. CASE PRESENTATION: On 19 September 2022, 3 h after the commencement of the right-sided weakness, a 61-year-old black African male farmer was sent to transported to the emergency room. When an radiography of the chest was performed, it showed diffuse bilateral infiltrates, coarse, slightly bilateral crepitation, and scattered reticulations. Cardiovascular testing of the patient turned up nothing unexpected. The eye-opening reaction was 1/4 (no eye opening) on the Glasgow Coma Scale, the motor response was 3/6 (abnormal flexion), and the verbal response was 3/5 (inappropriate words). When his breathing became difficult, he needed five intranasal doses of oxygen every minute to maintain saturation. He started taking low-dose aspirin daily for a month at 81 mg. He took consumed 75 mg of clopidogrel once a day for a month. CLINICAL DISCUSSION: Stroke was associated with in-hospital death among hospitalized patients with the COVID-19 infection. In patients who have risk factors for stroke, such as high blood pressure, obesity, and diabetes, COVID-19 increases the risk of stroke. The risk of stroke was highest in older people within the first few days after receiving a COVID-19 diagnosis. CONCLUSION: Patients with COVID-19 are more likely to get an ischemic stroke from large infarctions, mostly as a result of major artery thrombosis. From the start of COVID-19 signs, neurological problems can appear anywhere between 3 and 14 days later. Due to severe inflammation, immobility, hypoxia, and diffuse intravascular coagulation, SARS-CoV-2 also possesses neurological invasive capabilities and may migrate from the respiratory system to the central nervous system.

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