Introduction: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which is the agent of Coronavirus disease 2019 (COVID-19), may attack the central nervous system in addition to the respiratory system because of its neuro-invasive features. Increased inflammation, immobilization, hypoxia, and disseminated intravascular coagulation may predispose to the cerebrovascular diseases.
Case Report: A 73 years old man presenting to the emergency service with complaints of dyspnea, cough, and high fever was admitted to the hospital after being diagnosed as having COVID-19 upon findings of ground-glass densities and mild parenchymal involvement which was more prominent in the mid- and lower lobes of the lungs on his computerized tomography scan. His treatment was started with chloroquine, azithromycin, ceftriaxone and enoxaparin. On the neurological exam performed for symptoms of dizziness, imbalance, speech disorder and deviation of angle of mouth; he was conscious, cooperating, oriented limitedly and the right nasolabial groove was indistinct and he had dysarthria and ataxia. Acetyl salicylic acid was added to the treatment because cerebral diffusion magnetic resonance imaging revealed limited diffusion consistent with acute ischemia on the right posterolateral area of the bulbus. The patient whose respiratory distress worsened and who was admitted to the intensive care unit developed cardiac and respiratory arrest and he died despite all efforts of resuscitation.
Conclusion: It should be kept in mind that the elderly patients with Covid-19 with prothrombotic risk factors are also at risk for cerebrovascular disease in addition to the infectious symptoms. In this case report, a patient infected with SARS-CoV-2 and diagnosed as acute ischemic stroke with anamnesis, clinical and radiological findings is presented.
Guan W, Ni Z, Hu Y, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720. doi:10.1056/NEJMoa2002032
COVID-19 Map - Johns Hopkins Coronavirus Resource Center. Accessed May 29, 2020. https://coronavirus.jhu.edu/map.html
Mao L, Jin H, Wang M, et al. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. Published online April 10, 2020. doi:10.1001/jamaneurol.2020.1127
Öztürk Ş. Nörolojik Bakış Açısından COVID-19. Turkish J Neurol. Published online May 19, 2020. doi:10.4274/tnd.2020.73669
Klok FA, Kruip MJHA, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res. Published online 2020. doi:10.1016/j.thromres.2020.04.013
Li Y, Wang M, Zhou Y, et al. Acute Cerebrovascular Disease Following COVID-19: A Single Center, Retrospective, Observational Study. SSRN Electron J. Published online 2020. doi:10.2139/ssrn.3550025
Levi M, Van Der Poll T. Coagulation in sepsis: All bugs bite equally. Crit Care. 2004;8(2):99-100. doi:10.1186/cc2816
Sorgun MH. COVID-19. (Memikoğlu O, Genç V, eds.). Ankara Üniversitesi; 2020.
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