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|Ischemic stroke- 32 patients (0.9%)
|Ischemic stroke- 32 patients (0.9%)
|-
|-
|April 6, 2020
|April 28, 2020
|European countries
|New York city
|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>
|Oxley et al.<ref name="OxleyMocco2020">{{cite journal|last1=Oxley|first1=Thomas J.|last2=Mocco|first2=J.|last3=Majidi|first3=Shahram|last4=Kellner|first4=Christopher P.|last5=Shoirah|first5=Hazem|last6=Singh|first6=I. Paul|last7=De Leacy|first7=Reade A.|last8=Shigematsu|first8=Tomoyoshi|last9=Ladner|first9=Travis R.|last10=Yaeger|first10=Kurt A.|last11=Skliut|first11=Maryna|last12=Weinberger|first12=Jesse|last13=Dangayach|first13=Neha S.|last14=Bederson|first14=Joshua B.|last15=Tuhrim|first15=Stanley|last16=Fifi|first16=Johanna T.|title=Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young|journal=New England Journal of Medicine|volume=382|issue=20|year=2020|pages=e60|issn=0028-4793|doi=10.1056/NEJMc2009787}}</ref>
|417
|5
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|85.6%
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|Large vessel stroke. (Mean age-<50 years)
|-
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|April 7, 2020
|April 7, 2020

Revision as of 11:26, 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 Ischemic/Hemorrhagic Stroke
April 10, 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 group Ischemic-4, Hemorrhagic-1
May 29, 2020 Wuhan, China Qin et al.[2] 1875 461 severe on admission 50 patients ie. 15 among severe and 35 among mild on admission (Median age-70 years), 30 males and 20 females
May 20, 2020 New York Yaghi et al.[3] 3556 Ischemic stroke- 32 patients (0.9%)
April 28, 2020 New York city Oxley et al.[4] 5 Large vessel stroke. (Mean age-<50 years)
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. ↑ Qin, Chuan; Zhou, Luoqi; Hu, Ziwei; Yang, Sheng; Zhang, Shuoqi; Chen, Man; Yu, Haihan; Tian, Dai-Shi; Wang, Wei (2020). "Clinical Characteristics and Outcomes of COVID-19 Patients With a History of Stroke in Wuhan, China". Stroke. 51 (7): 2219–2223. doi:10.1161/STROKEAHA.120.030365. ISSN 0039-2499.
  3. ↑ Yaghi, Shadi; Ishida, Koto; Torres, Jose; Mac Grory, Brian; Raz, Eytan; Humbert, Kelley; Henninger, Nils; Trivedi, Tushar; Lillemoe, Kaitlyn; Alam, Shazia; Sanger, Matthew; Kim, Sun; Scher, Erica; Dehkharghani, Seena; Wachs, Michael; Tanweer, Omar; Volpicelli, Frank; Bosworth, Brian; Lord, Aaron; Frontera, Jennifer (2020). "SARS-CoV-2 and Stroke in a New York Healthcare System". Stroke. 51 (7): 2002–2011. doi:10.1161/STROKEAHA.120.030335. ISSN 0039-2499.
  4. ↑ Oxley, Thomas J.; Mocco, J.; Majidi, Shahram; Kellner, Christopher P.; Shoirah, Hazem; Singh, I. Paul; De Leacy, Reade A.; Shigematsu, Tomoyoshi; Ladner, Travis R.; Yaeger, Kurt A.; Skliut, Maryna; Weinberger, Jesse; Dangayach, Neha S.; Bederson, Joshua B.; Tuhrim, Stanley; Fifi, Johanna T. (2020). "Large-Vessel Stroke as a Presenting Feature of Covid-19 in the Young". New England Journal of Medicine. 382 (20): e60. doi:10.1056/NEJMc2009787. ISSN 0028-4793.
  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. ↑ Invalid <ref> tag; no text was provided for refs named MoeinHashemian20202
  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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