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Pandemic and Neurointervention
Ischemic stroke in COVID-19-positive patients: an overview of SARS-CoV-2 and thrombotic mechanisms for the neurointerventionalist
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  1. Amanda Zakeri1,
  2. Ashutosh P Jadhav2,
  3. Bruce A Sullenger3,
  4. Shahid M Nimjee1
  1. 1 Neurosurgery, The Ohio State University Medical Center, Columbus, Ohio, USA
  2. 2 Neurosurgery, Barrow Neurological Institute, Phoenix, Arizona, USA
  3. 3 Surgery, Duke University Medical Center, Durham, North Carolina, USA
  1. Correspondence to Dr Shahid M Nimjee, Neurological Surgery, The Ohio State University Medical Center, Columbus, OH 43210, USA; shahid.nimjee{at}gmail.com

Abstract

Coronavirus disease 2019 (COVID-19) results from infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first reported in Wuhan, China in patients suffering from severe pneumonia and acute respiratory distress syndrome and has now grown into the first pandemic in over 100 years. Patients infected with SARS-CoV-2 develop arterial thrombosis including stroke, myocardial infarction and peripheral arterial thrombosis, all of which result in poor outcomes despite maximal medical, endovascular, and microsurgical treatment compared with non-COVID-19-infected patients. In this review we provide a brief overview of SARS-CoV-2, the infectious agent responsible for the COVID-19 pandemic, and describe the mechanisms responsible for COVID-19-associated coagulopathy. Finally, we discuss the impact of COVID-19 on ischemic stroke, focusing on large vessel occlusion.

  • inflammation
  • inflammatory response
  • platelets
  • stroke
  • COVID-19

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/neurintsurg-2020-016794

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    Footnotes

    • Contributors AZ contributed to drafting and revising the manuscript. APJ contributed to the conception, drafting, and revising the manuscript. BAS contributed to the conception, drafting, and revising the manuscript. SMN contributed to conception, research, drafting, and revising the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.