Papi Claudia, Spagni Gregorio, Alexandre Andrea, Calabresi Paolo, Della Marca Giacomo, Broccolini Aldobrando
Area Neuroscienze, UOC Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Area Diagnostica per Immagini, UOC Radiologia e Neuroradiologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
J Stroke Cerebrovasc Dis. 2020 Sep;29(9):104981. doi: 10.1016/j.jstrokecerebrovasdis.2020.104981. Epub 2020 May 23.
Coronavirus disease 19 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this scenario, managing acute medical conditions, such as stroke, requires a timely treatment together with proper strategies that minimize the risk of infection spreading to health care workers and other patients. We report the case of a 79-year-old woman, who was admitted for a wake-up stroke due to occlusion of the left middle cerebral artery. She was treated outside the COVID-19-dedicated track of the hospital because she had no concomitant signs or symptoms suggestive of SARS-CoV-2 infection nor recent contact with other infected individuals. Post-mortem nasal and pharyngeal swab was positive for SARS-CoV-2 infection. We propose that hyperacute stroke patients should be tested for SARS-CoV-2 infection at admission and then managed as having COVID-19 until cleared by a negative result. We are aware that such measure results in some delay of the acute treatment of stroke, which could be minimal using well-exercised containment protocols.
冠状病毒病19（COVID-19）是由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的一种新发传染病。在这种情况下，管理诸如中风等急性疾病需要及时治疗，并采取适当策略，以尽量减少感染传播给医护人员和其他患者的风险。我们报告了一例79岁女性患者的病例，该患者因左大脑中动脉闭塞导致醒后卒中入院。由于她没有提示SARS-CoV-2感染的伴随体征或症状，也没有近期与其他感染者接触史，因此在医院的非COVID-19专用通道接受治疗。尸检时鼻拭子和咽拭子SARS-CoV-2感染呈阳性。我们建议超急性中风患者入院时应进行SARS-CoV-2感染检测，然后按COVID-19患者进行管理，直至检测结果为阴性。我们意识到，这种措施会导致中风急性治疗出现一些延迟，但通过完善的防控方案，这种延迟可能会降至最低。
