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== University Education ==
== University Education ==


*The [[prevalence]] of [[COVID-19]]-associated [[stroke]] vary depending on study population (country, race, gender)


{| class="wikitable"
{| class="wikitable"
 
|+Prevalence of stroke in patients with COVID-19
!Date of publication
!Country
!Author
!Number of patients
!Severe infection
!Neurological symptoms
!Acute Cerebrovascular disease
|-
|April 10th, 2020
|Wuhan, China
|Mao et al.<ref name="MaoJin2020">{{cite journal|last1=Mao|first1=Ling|last2=Jin|first2=Huijuan|last3=Wang|first3=Mengdie|last4=Hu|first4=Yu|last5=Chen|first5=Shengcai|last6=He|first6=Quanwei|last7=Chang|first7=Jiang|last8=Hong|first8=Candong|last9=Zhou|first9=Yifan|last10=Wang|first10=David|last11=Miao|first11=Xiaoping|last12=Li|first12=Yanan|last13=Hu|first13=Bo|title=Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China|journal=JAMA Neurology|volume=77|issue=6|year=2020|pages=683|issn=2168-6149|doi=10.1001/jamaneurol.2020.1127}}</ref>
|214
|88 patients (41.1%), Mean age-58.2 years
|78 patients (36.4%)
|5 among severe [5.7%] infection group vs 1 [0.8%]) in non-severe
|-
|March 27, 2020
|Iran
|Bagheri et al.<ref name="BagheriAsghari2020">{{cite journal|last1=Bagheri|first1=Seyed Hamid Reza|last2=Asghari|first2=Ali Mohammad|last3=Farhadi|first3=Mohammad|last4=Shamshiri|first4=Ahmad Reza|last5=Kabir|first5=Ali|last6=Kamrava|first6=Seyed Kamran|last7=Jalessi|first7=Maryam|last8=Mohebbi|first8=Alireza|last9=Alizadeh|first9=Rafieh|last10=Honarmand|first10=Ali Asghar|last11=Ghalehbaghi|first11=Babak|last12=Salimi|first12=Alireza|year=2020|doi=10.1101/2020.03.23.20041889}}</ref>
|10,069
|48.23%
|
|-
|April 1, 2020
|Italy
|Vaira et al.<ref name="pmid32237238">{{cite journal |vauthors=Vaira LA, Salzano G, Deiana G, De Riu G |title=Anosmia and Ageusia: Common Findings in COVID-19 Patients |journal=Laryngoscope |volume=130 |issue=7 |pages=1787 |date=July 2020 |pmid=32237238 |pmc=7228304 |doi=10.1002/lary.28692 |url=}}</ref>
|320
|
|19.4%
|
|-
|April 6, 2020
|European countries
|Lechien et al.<ref name="pmid32253535">{{cite journal |vauthors=Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, Dequanter D, Blecic S, El Afia F, Distinguin L, Chekkoury-Idrissi Y, Hans S, Delgado IL, Calvo-Henriquez C, Lavigne P, Falanga C, Barillari MR, Cammaroto G, Khalife M, Leich P, Souchay C, Rossi C, Journe F, Hsieh J, Edjlali M, Carlier R, Ris L, Lovato A, De Filippis C, Coppee F, Fakhry N, Ayad T, Saussez S |title=Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study |journal=Eur Arch Otorhinolaryngol |volume= |issue= |pages= |date=April 2020 |pmid=32253535 |pmc=7134551 |doi=10.1007/s00405-020-05965-1 |url=}}</ref>
|417
|
|85.6%
|
|-
|April 7, 2020
|United Kingdom
|Menni et al.<ref name="MenniValdes20202">{{cite journal|last1=Menni|first1=Cristina|last2=Valdes|first2=Ana|last3=Freydin|first3=Maxim B|last4=Ganesh|first4=Sajaysurya|last5=El-Sayed Moustafa|first5=Julia|last6=Visconti|first6=Alessia|last7=Hysi|first7=Pirro|last8=Bowyer|first8=Ruth C E|last9=Mangino|first9=Massimo|last10=Falchi|first10=Mario|last11=Wolf|first11=Jonathan|last12=Steves|first12=Claire|last13=Spector|first13=Tim|year=2020|doi=10.1101/2020.04.05.20048421}}</ref>
|579
|
|59.41%
|
|-
|April 12, 2020
|United States
|Yan et al.<ref name="pmid322794412">{{cite journal |vauthors=Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS |title=Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms |journal=Int Forum Allergy Rhinol |volume= |issue= |pages= |date=April 2020 |pmid=32279441 |pmc=7262089 |doi=10.1002/alr.22579 |url=}}</ref>
|59
|
|68%
|
|-
|April 16, 2020
|France
|Klopfenstein et al.<ref name="KlopfensteinKadiane-Oussou2020">{{cite journal|last1=Klopfenstein|first1=T.|last2=Kadiane-Oussou|first2=N.J.|last3=Toko|first3=L.|last4=Royer|first4=P.-Y.|last5=Lepiller|first5=Q.|last6=Gendrin|first6=V.|last7=Zayet|first7=S.|title=Features of anosmia in COVID-19|journal=Médecine et Maladies Infectieuses|year=2020|issn=0399077X|doi=10.1016/j.medmal.2020.04.006}}</ref>
|47
|
|47%
|
|-
|-
 
|April 17, 2020
! Patient no.
|Iran
 
|Moein et al.<ref name="MoeinHashemian20202" />
! Onset of neurologic symptoms <BR />
|60
 
|
! Neurologic Signs & Symptoms <ref>{{cite journal|doi=10.1016/j.bbi.2020.04.077.}}</ref>
|98.33%
 
|
|-
|-
 
|April 22, 2020
|1
|United Kingdom
 
|Spinato et al.<ref name="SpinatoFabbris2020">{{cite journal|last1=Spinato|first1=Giacomo|last2=Fabbris|first2=Cristoforo|last3=Polesel|first3=Jerry|last4=Cazzador|first4=Diego|last5=Borsetto|first5=Daniele|last6=Hopkins|first6=Claire|last7=Boscolo-Rizzo|first7=Paolo|title=Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection|journal=JAMA|volume=323|issue=20|year=2020|pages=2089|issn=0098-7484|doi=10.1001/jama.2020.6771}}</ref>
|On Admission
|202
 
|
| Respiratory distress, fever, and altered mental status
|64.4%
 
|
|-
|-
 
|April 22, 2020
|2
|Iran
 
|Heidari et al.<ref name="HeidariKarimi2020">{{cite journal|last1=Heidari|first1=F.|last2=Karimi|first2=E.|last3=Firouzifar|first3=M.|last4=Khamushian|first4=P.|last5=Ansari|first5=R.|last6=Mohammadi Ardehali|first6=M.|last7=Heidari|first7=F.|title=Anosmia as a Prominent Symptom of COVID-19 Infection|journal=Rhinology journal|volume=58|issue=3|year=2020|pages=302–303|issn=03000729|doi=10.4193/Rhin20.140}}</ref>
|On Admission
|23
 
|
|fever, slurring of speech, facial droop, and reduced oral intake
|69.57%
 
|
|-
|-
 
|April 22, 2020
|3
|Spain
 
|Beltran-Corbellini et al.<ref name="Beltrán‐CorbelliniChico‐García2020">{{cite journal|last1=Beltrán‐Corbellini|first1=Á.|last2=Chico‐García|first2=J. L.|last3=Martínez‐Poles|first3=J.|last4=Rodríguez‐Jorge|first4=F.|last5=Natera‐Villalba|first5=E.|last6=Gómez‐Corral|first6=J.|last7=Gómez‐López|first7=A.|last8=Monreal|first8=E.|last9=Parra‐Díaz|first9=P.|last10=Cortés‐Cuevas|first10=J. L.|last11=Galán|first11=J. C.|last12=Fragola‐Arnau|first12=C.|last13=Porta‐Etessam|first13=J.|last14=Masjuan|first14=J.|last15=Alonso‐Cánovas|first15=A.|title=Acute‐onset smell and taste disorders in the context of COVID‐19: a pilot multicentre polymerase chain reaction based case–control study|journal=European Journal of Neurology|year=2020|issn=1351-5101|doi=10.1111/ene.14273}}</ref>
|On Admission
|79
 
|
| Left sided weakness, altered mental weakness, one week history of frequent falls
|31.65%
 
|
|-
|-
 
|April 24, 2020
|4
|United States
 
|Yan et al.<ref name="YanFaraji2020">{{cite journal|last1=Yan|first1=Carol H.|last2=Faraji|first2=Farhoud|last3=Prajapati|first3=Divya P.|last4=Ostrander|first4=Benjamin T.|last5=DeConde|first5=Adam S.|title=Self‐reported olfactory loss associates with outpatient clinical course in COVID‐19|journal=International Forum of Allergy & Rhinology|year=2020|issn=2042-6976|doi=10.1002/alr.22592}}</ref>
| On Admission
|169
 
|
| An 15 minute episode of weakness and numbness of right arm and word finding difficulty
|75.7%
 
|
|-
|-
 
|May 1, 2020
|5
|Germany
 
|Luers et al.<ref name="HeindlLehmann2020">{{cite journal|last1=Heindl|first1=Ludwig M|last2=Lehmann|first2=Clara|last3=Klein|first3=Florian|last4=Dewald|first4=Felix|last5=Augustin|first5=Max|last6=Wawer Matos|first6=Philomena A|last7=Loreck|first7=Niklas|last8=Rokohl|first8=Alexander C|last9=Luers|first9=Jan C|title=Olfactory and Gustatory Dysfunction in Coronavirus Disease 19 (COVID-19)|journal=Clinical Infectious Diseases|year=2020|issn=1058-4838|doi=10.1093/cid/ciaa525}}</ref>
|7 days after cough,ageusia and anosmia
|72
 
|
|facial weakness,flaccid areflexic paraplegia(day 2-3) and respiratory failure (day 4)
|74%
 
|
|-
|-
|May 1, 2020
|Italy
|Vaira et al.<ref name="VairaSalzano2020">{{cite journal|last1=Vaira|first1=Luigi Angelo|last2=Salzano|first2=Giovanni|last3=Petrocelli|first3=Marzia|last4=Deiana|first4=Giovanna|last5=Salzano|first5=Francesco Antonio|last6=De Riu|first6=Giacomo|title=Validation of a self-administered olfactory and gustatory test for the remotely evaluation of COVID-19 patients in home quarantine|journal=Head & Neck|year=2020|issn=10433074|doi=10.1002/hed.26228}}</ref>
|33
|
|75.8%
|


|}
|}<br />
 
 
 
 
 
 
 
 
 




Revision as of 09:59, 12 July 2020

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University Education

Prevalence of stroke in patients with COVID-19
Date of publication Country Author Number of patients Severe infection Neurological symptoms Acute Cerebrovascular disease
April 10th, 2020 Wuhan, China Mao et al.[1] 214 88 patients (41.1%), Mean age-58.2 years 78 patients (36.4%) 5 among severe [5.7%] infection group vs 1 [0.8%]) in non-severe
March 27, 2020 Iran Bagheri et al.[2] 10,069 48.23%
April 1, 2020 Italy Vaira et al.[3] 320 19.4%
April 6, 2020 European countries Lechien et al.[4] 417 85.6%
April 7, 2020 United Kingdom Menni et al.[5] 579 59.41%
April 12, 2020 United States Yan et al.[6] 59 68%
April 16, 2020 France Klopfenstein et al.[7] 47 47%
April 17, 2020 Iran Moein et al.[8] 60 98.33%
April 22, 2020 United Kingdom Spinato et al.[9] 202 64.4%
April 22, 2020 Iran Heidari et al.[10] 23 69.57%
April 22, 2020 Spain Beltran-Corbellini et al.[11] 79 31.65%
April 24, 2020 United States Yan et al.[12] 169 75.7%
May 1, 2020 Germany Luers et al.[13] 72 74%
May 1, 2020 Italy Vaira et al.[14] 33 75.8%










University Education

Syncope is classified yo three categories:

 
 
 
Box 1 in Row 1
 
Box in Row 1
 
 


 
 
 
Box 1 in Row 1
 
 
 
 
Box in Row 1
 
 
 
 
 


 
 
 
Box 1 in Row 1
 
Box in Row 1
 
 


 
 
 
Box 1 in Row 1
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Box 2 in Row 2
 
 
 
 
 
 
Box 1 in Row 1
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Box 2 in Row 2
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Box 3 in Row 3
 
 
 
Box 4 in Row 4
Case courtesy of Dr Subhan Iqbal, Radiopaedia.org, rID: 76341


DDx of syncope
  1. ↑ Mao, Ling; Jin, Huijuan; Wang, Mengdie; Hu, Yu; Chen, Shengcai; He, Quanwei; Chang, Jiang; Hong, Candong; Zhou, Yifan; Wang, David; Miao, Xiaoping; Li, Yanan; Hu, Bo (2020). "Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China". JAMA Neurology. 77 (6): 683. doi:10.1001/jamaneurol.2020.1127. ISSN 2168-6149.
  2. ↑ Bagheri, Seyed Hamid Reza; Asghari, Ali Mohammad; Farhadi, Mohammad; Shamshiri, Ahmad Reza; Kabir, Ali; Kamrava, Seyed Kamran; Jalessi, Maryam; Mohebbi, Alireza; Alizadeh, Rafieh; Honarmand, Ali Asghar; Ghalehbaghi, Babak; Salimi, Alireza (2020). doi:10.1101/2020.03.23.20041889. Missing or empty |title= (help)
  3. ↑ Vaira LA, Salzano G, Deiana G, De Riu G (July 2020). "Anosmia and Ageusia: Common Findings in COVID-19 Patients". Laryngoscope. 130 (7): 1787. doi:10.1002/lary.28692. PMC 7228304 Check |pmc= value (help). PMID 32237238 Check |pmid= value (help).
  4. ↑ Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, Dequanter D, Blecic S, El Afia F, Distinguin L, Chekkoury-Idrissi Y, Hans S, Delgado IL, Calvo-Henriquez C, Lavigne P, Falanga C, Barillari MR, Cammaroto G, Khalife M, Leich P, Souchay C, Rossi C, Journe F, Hsieh J, Edjlali M, Carlier R, Ris L, Lovato A, De Filippis C, Coppee F, Fakhry N, Ayad T, Saussez S (April 2020). "Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study". Eur Arch Otorhinolaryngol. doi:10.1007/s00405-020-05965-1. PMC 7134551 Check |pmc= value (help). PMID 32253535 Check |pmid= value (help).
  5. ↑ Menni, Cristina; Valdes, Ana; Freydin, Maxim B; Ganesh, Sajaysurya; El-Sayed Moustafa, Julia; Visconti, Alessia; Hysi, Pirro; Bowyer, Ruth C E; Mangino, Massimo; Falchi, Mario; Wolf, Jonathan; Steves, Claire; Spector, Tim (2020). doi:10.1101/2020.04.05.20048421. Missing or empty |title= (help)
  6. ↑ Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS (April 2020). "Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms". Int Forum Allergy Rhinol. doi:10.1002/alr.22579. PMC 7262089 Check |pmc= value (help). PMID 32279441 Check |pmid= value (help).
  7. ↑ Klopfenstein, T.; Kadiane-Oussou, N.J.; Toko, L.; Royer, P.-Y.; Lepiller, Q.; Gendrin, V.; Zayet, S. (2020). "Features of anosmia in COVID-19". Médecine et Maladies Infectieuses. doi:10.1016/j.medmal.2020.04.006. ISSN 0399-077X.
  8. ↑
  9. ↑ Spinato, Giacomo; Fabbris, Cristoforo; Polesel, Jerry; Cazzador, Diego; Borsetto, Daniele; Hopkins, Claire; Boscolo-Rizzo, Paolo (2020). "Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection". JAMA. 323 (20): 2089. doi:10.1001/jama.2020.6771. ISSN 0098-7484.
  10. ↑ Heidari, F.; Karimi, E.; Firouzifar, M.; Khamushian, P.; Ansari, R.; Mohammadi Ardehali, M.; Heidari, F. (2020). "Anosmia as a Prominent Symptom of COVID-19 Infection". Rhinology journal. 58 (3): 302–303. doi:10.4193/Rhin20.140. ISSN 0300-0729.
  11. ↑ Beltrán‐Corbellini, Á.; Chico‐García, J. L.; Martínez‐Poles, J.; Rodríguez‐Jorge, F.; Natera‐Villalba, E.; Gómez‐Corral, J.; Gómez‐López, A.; Monreal, E.; Parra‐Díaz, P.; Cortés‐Cuevas, J. L.; Galán, J. C.; Fragola‐Arnau, C.; Porta‐Etessam, J.; Masjuan, J.; Alonso‐Cánovas, A. (2020). "Acute‐onset smell and taste disorders in the context of COVID‐19: a pilot multicentre polymerase chain reaction based case–control study". European Journal of Neurology. doi:10.1111/ene.14273. ISSN 1351-5101.
  12. ↑ Yan, Carol H.; Faraji, Farhoud; Prajapati, Divya P.; Ostrander, Benjamin T.; DeConde, Adam S. (2020). "Self‐reported olfactory loss associates with outpatient clinical course in COVID‐19". International Forum of Allergy & Rhinology. doi:10.1002/alr.22592. ISSN 2042-6976.
  13. ↑ Heindl, Ludwig M; Lehmann, Clara; Klein, Florian; Dewald, Felix; Augustin, Max; Wawer Matos, Philomena A; Loreck, Niklas; Rokohl, Alexander C; Luers, Jan C (2020). "Olfactory and Gustatory Dysfunction in Coronavirus Disease 19 (COVID-19)". Clinical Infectious Diseases. doi:10.1093/cid/ciaa525. ISSN 1058-4838.
  14. ↑ Vaira, Luigi Angelo; Salzano, Giovanni; Petrocelli, Marzia; Deiana, Giovanna; Salzano, Francesco Antonio; De Riu, Giacomo (2020). "Validation of a self-administered olfactory and gustatory test for the remotely evaluation of COVID-19 patients in home quarantine". Head & Neck. doi:10.1002/hed.26228. ISSN 1043-3074.



Patient Past Medical History Later presentation GCS Lab. Findings Specific Tests Imaging studies
CBC CSF MRI/CT scan
1. 84-year old man in France presented with dyspnea and cough[1] Diabetes Mellitus,

Hypertension,

Atrial fibrillation,

Peripheral Arterial Disease,

Coronary Heart Disease

Worsening headache, Sore throat. (Day 5)

Impaired consciousness and transient generalized seizure, (Day 9)

E4V1M1 ↑WBCs and neutrophils
↓lymphocytes

↑ CRP

Clear and colorless fluid,

Pressure=320 mmH2O,

Cell count was 12/μL–10

mononuclear and 2 polymorphonuclear cells

RT-PCR for SARS-CoV-2 was positive in nasopharyngeal swab Brain MRI:

Hyperintensity in the right lateral ventricle's inferior horn along the wall,

pan-paranasal sinusitis.

2. 74-year old man in France presented with confusion and influenza-like illness[1] Flu like symptoms Headache, nausea, dizziness, and

drug-refractory seizures.

E4V5M6 NA NA RT-PCR and antibody tests positive Brain MRI: Hyperintensity in the left temporal lobe.

MR Spectroscopy: Decrease N-acetyl aspartate peak along with a marked elevated choline peak.

3. 31-year-old African American woman[2] SCD patient with dyspnea Paralysis and sedation (Day 13)

Comatose (Day 15) and death (Day 16)

E0V0M0 NA Pressure=30cmH2O

115 nucleated cell /ml

7374 erythrocytes

/ml

Protein> 200mg/dl

RT=PCR for SARS-CoV-2 was positive in nasopharyngeal swab Brain MRI: Nonenhancing cerebral edema and restricted diffusion in the right cerebral hemisphere with brain herniation.
  1. ↑ 1.0 1.1 Zayet, Souheil; Klopfenstein, Timothée; Kovẚcs, Róbert; Stancescu, Silviu; Hagenkötter, Beate (2020). "Acute Cerebral Stroke with Multiple Infarctions and COVID-19, France, 2020". Emerging Infectious Diseases. 26 (9). doi:10.3201/eid2609.201791. ISSN 1080-6040.
  2. ↑ Benameur K, Agarwal A, Auld SC, Butters MP, Webster AS, Ozturk T; et al. (2020). "Encephalopathy and Encephalitis Associated with Cerebrospinal Fluid Cytokine Alterations and Coronavirus Disease, Atlanta, Georgia, USA, 2020". Emerg Infect Dis. 26 (9). doi:10.3201/eid2609.202122. PMID 32487282 Check |pmid= value (help).
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