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2020, Number 4

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Rev Cub Med Int Emerg 2020; 19 (4)

Cerebrovascular disease during the COVID-19 pandemic

Piedra GM, Piedra GM, García MER

Language: Spanish
References: 30
Page: 1-16
PDF size: 219.35 Kb.


ABSTRACT

Introduction: There is contradictory information about the incidence of cerebrovascular disease in COVID-19 patients, and about the risk of patients with history of cerebrovascular disease of suffering from SARS-CoV-2 infection.
Objective: To describe the essential theoretical bases on the relationship between cerebrovascular disease and coronavirus infection. Acquisition of evidence: A bibliographic review was carried out in databases as Infomed, Bibliomed, Medline, from March to May 2020, to collect all the existing information on the relationship between cerebrovascular disease and coronavirus infection, since the beginning of the pandemic. Generalities, epidemiology, mechanisms of neurological involvement, reports of patients with cerebrovascular disorders and stroke management in patients with COVID-19 were investigated. The keywords used for this review were coronavirus infection, SARS-CoV-2, COVID-19, cerebrovascular disease. A total of 40 articles were reviewed. The consultations were made in English and Spanish.
Results: The virus penetrates the central nervous system by hematogenous or retrograde neuronal route and it is believed that it could cause stroke by several mechanisms: invasion of the vascular wall, coagulopathy associated with COVID-19 and myocardial damage with cerebral embolism or destabilization of a plaque of pre-existing atheroma. The general management of stroke has little influence on the high death rate from COVID-19.
Conclusions: The risk of stroke may occur more in patients with SARS-CoV.2 infection. In these cases, it can even be the presentation of the disease. Patients with history of stroke are at high risk of dying from COVID-19. Stroke is produced by three mechanisms: invasion of the vascular wall, coagulopathy associated with COVID-19, and myocardial damage with cerebral embolism or destabilization of a pre-existing atheroma plaque.


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