Concurrent Cardio-Cerebral Infarctions in COVID-19: A Systematic Review of Published Case Reports/ Series

• Type of Material: Article
• Authors: Rupak Desai, Atlanta VA Medical Center; Avilash Mondal, Nazareth Hospital; Abhishek Prasad, Duke University; Ankit Vyas, Baptist Hospitals of Southeast Texas; Akhil Jain, Mercy Catholic Medical Center; Chintan Rupareliya, University of Texas Southwestern Medical Center; Manan Shah, Augusta University; Timir Paul, University of Tennessee Health Sciences Center at Nashville; Gautam Kumar, Emory University; Rajesh Sachdeva, Emory University
• Language: English
• Date: 2023-06-14
• Publisher: MOSBY-ELSEVIER
• Publication Version: Final Published Version
• Copyright Statement: © 2023 Elsevier
• Final Published Version (URL): http://dx.doi.org/10.1016/j.cpcardiol.2023.101814
• Title of Journal or Parent Work: CURRENT PROBLEMS IN CARDIOLOGY
• Volume: 48
• Issue: 10
• Start Page: 101814
• End Page: 101814
• Keywords: STROKE; Science & Technology; THROMBOSIS; Cardiac & Cardiovascular Systems; Life Sciences & Biomedicine; Cardiovascular System & Cardiology

Abstract

Twelve CCI patients were studied with confirmed or suspected COVID-19 infection. The majority of these patients were males (83.3%) with a median age of 55 years from three geographical locations, constituting the Middle East (7), Spain (3), and the USA (1). In 6 patients, IgG/IgM was positive for COVID-19, 4 with high pretest probability and 2 with positive RT-PCR. Type 2 DM, hyperlipidemia, and smoking were the primary risk factors. Right-sided neurological impairments and verbal impairment were the most common symptoms. Our analysis found 8 (66%) synchronous occurrences. In 58.3% of cases, neuroimaging showed left Middle Cerebral Artery (MCA) infarct and 33.3% right. Carotid artery thrombosis (16.6%), tandem occlusion (8.3%), and carotid stenosis (1%) were also reported in imaging. Dual antiplatelet therapy (DAPT) and anticoagulants were conservative therapies (10). Two AMI patients had aspiration thrombectomy, while three AIS patients had intravenous thrombolysis/tissue plasminogen activator (IVT-tPA), 2 had mechanical thrombectomy (MT), and 1 had decompressive craniotomy. Five had COVID-19-positive chest X-rays, whereas 4 were normal. four of 8 STEMI and 3 NSTEMI/UA patients complained chest pain. LV, ICA, and pulmonary embolism were further complications (2). Upon discharge, 7 patients (70%) had residual deficits while 1 patient unfortunately died.