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Ischemic stroke associated with COVID-19 in a young patient: A case report

2021; Wiley; Volume: 28; Linguagem: Inglês

1468-1331

Matheus Fleury Alves, Gabriel S. Rocha, GUTEMBERG CARDOSO DA SILVA, A. Da Silva César, Wellington Carlos Marques Botelho, Maria Lopes Pereira, Carmélia Matos Santiago Reis, Elena Segundo, Ianny Costa Moura de Paiva,

Heme Oxygenase-1 and Carbon Monoxide

Background and aims: Although it primarily damages the respiratory system, COVID-19 can also develops with neurological conditions such as stroke. This study aims to describe a case report of a patient with ischemic stroke related to COVID-19. Methods: Male, 44 years old, with untreated diabetes, admitted to emergency with left hemiplegia and dysarthria. Patient had flu-like symptoms 11 days ago and was diagnosed with COVID-19. Auscultation revealed bilateral bases rhonchi. Normotensive, oxygen saturation: 94%, glycemia: 241mg/dl, increased lactate and CRP;hemogram, D-Dimer and coagulogram unchanged. Brain CT demonstrated no evidence of hemorrhagic injury. Chest CT revealed bilateral lung involvement with ground-glass opacities. The patient remained hospitalized for 21 days and was discharged still with motor deficits. Results: The literature suggests that the mechanisms of ischemic stroke associated with COVID-19 are multiple, highlighting the cytokine storm and coagulation dysfunction. Increased lactate and CRP suggest an acute inflammatory activity;however, the patient did not exhibit high levels of D-dimer, platelet or coagulogram changes. Strokes associated with COVID-19 occur mainly in elderly patients and critically sick. Patients with mild clinical presentation of the disease have an incidence of strokes less than 1%. Although the patient does not have the risk factors mentioned above, diabetes may represent a predisposing factor of the neurological complication. Conclusion: Patients with mild respiratory conditions may present severe neurological complications, possibly due to the association between previous comorbidity and coagulopathy from COVID-19. The strokes associated with COVID-19 may present greater mortality and disability when compared to cases unrelated to COVID-19.