The Baffling Case of Ischemic Stroke Disappearance from the Casualty Department in the COVID-19 Era

• Published in: European Neurology Vol. 83; no. 2; pp. 213 - 3
• Main Authors: Morelli, Nicola, Rota, Eugenia, Terracciano, Chiara, Immovilli, Paolo, Spallazzi, Marco, Colombi, Davide, Zaino, Domenica, Michieletti, Emanuele, Guidetti, Donata
• Format: Journal Article Web Resource
• Language: English
• Published: Switzerland S. Karger AG 2020
• Subjects: Betacoronavirus; Brain Ischemia; Coronavirus Infections; COVID-19; Humans; Myocardial Infarction; Pandemics; Pneumonia, Viral; SARS-CoV-2; Scotland; Stroke; Scotland
• ISSN: 1421-9913
• DOI: 10.1159/000507666

LVO strokes are always disabling (i.e., aphasia and/or hemiplegia), and it is impossible to avoid hospitalization in such a serious condition. [...]the point is that there may be an underestimation of the number of stroke, as when patients arrive in a Casualty Department with fever and respiratory distress, they take priority and the neurological deficit may, therefore, be overlooked. [...]in COVID-19 affected patients, high levels of thrombosis and inflammation serum markers, such as D-dimer, fibrinogen, and C-reactive protein, have been reported, as well as increased levels of inflammatory cytokines (i.e., tumor necrosis factor-α, interleukin [IL]-2R, and IL-6) [8]. Furthermore, based on previous evidence, the burden of chronic persistent infections and/or past infections, rather than one single current infectious disease, seems to be associated with stroke risk [13]. [...]the extraordinary measures taken by the Italian government might have reduced the spread of seasonal flu and its unfavorable effect upon stroke incidence.