Cerebrovascular events in COVID-19 patients

• Published in: Monaldi archives for chest disease Vol. 90; no. 2
• Main Authors: Mishra, Ajay Kumar, Sahu, Kamal Kant, George, Anu Anna, Sargent, Jennifer, Lal, Amos
• Format: Journal Article
• Language: English
• Published: Italy PAGEPress Publications 10.06.2020
• Subjects: Betacoronavirus; Cerebrovascular Disorders - epidemiology; Cerebrovascular Disorders - etiology; cerebrovascular events; Coronavirus Infections - complications; COVID-19; Critical Illness; Global Health; Humans; imaging; Incidence; mechanism; outcome; Pandemics; Pneumonia, Viral - complications; SARS-CoV-2
• ISSN: 1122-0643; 2532-5264
• DOI: 10.4081/monaldi.2020.1341

Neurological manifestations in patients with COVID-19 are more frequently being reported. Cerebrovascular events have been reported in around 3% of patients. In this review we summarize the published literature on cerebrovascular events in patients with COVID-19 as available on the PubMed database. So far, 3 studies have reported cerebrovascular events. Cerebrovascular events were identified on screening patients with decreased consciousness or in the presence of focal neurological deficits. These events were common in elderly, critically ill patients and in patients with prior cardio-cerebrovascular comorbidities. The diagnosis of cerebrovascular events was confirmed with computed tomography of the brain in most studies reporting neurological events. Multiple pathological mechanisms have been postulated regarding the process of neurological and vascular injury among which cytokine storm is shown to correlate with mortality. Patients with severe illness are found to have a higher cardio- cerebrovascular comorbidity. With an increasing number of cases and future prospective studies, the exact mechanism by which these cerebrovascular events occur and attribute to the poor outcome will be better understood.