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新型冠状病毒肺炎合并急性缺血性脑卒中患者的临床特征:从流行病学到结局。

Clinical Characteristics of Inpatients with Coronavirus Disease 2019 and Acute Ischemic Stroke: From Epidemiology to Outcomes.

机构信息

Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Curr Neurovasc Res. 2020;17(5):760-764. doi: 10.2174/1567202617999201110200410.

Abstract

Acute Ischemic Stroke (AIS) is currently the most frequently reported neurological complication of Coronavirus disease 2019 (COVID-19). This article will elaborate the clinical features of inpatients with COVID-19 and AIS and the pathophysiological mechanism of AIS under the background of COVID-19. Through a detailed search of relevant studies, we found that the incidence of AIS among COVID-19 patients varied from 0.9% to 4.6%, and AIS has been observed in many people without an underlying disease and cardiovascular risk factors as well as young people. The National Institute of Health Stroke Scale (NIHSS) score of COVID-19 patients with AIS was higher than historical AIS patients, and the proportion of large vessel occlusion (LVO) was about 64.2%. COVID-19 patients with AIS generally have high levels of D-D dimer, fibrinogen, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), suggesting systemic hyperinflammatory and hypercoagulable state. The pooled mortality of COVID-19 patients with AIS was 38% and the mortality of LVO patients is higher (45.9%). Compared with COVID-19-negative AIS patients in the same period in 2020 and 2019, COVID-19 patients with AIS had a worse prognosis.

摘要

急性缺血性脑卒中(AIS)是目前报道的 2019 年冠状病毒病(COVID-19)最常见的神经并发症。本文将详细阐述 COVID-19 住院患者的临床特征以及 COVID-19 背景下 AIS 的病理生理机制。通过对相关研究的详细检索,我们发现 COVID-19 患者中 AIS 的发病率为 0.9%至 4.6%,并且在许多没有基础疾病和心血管危险因素的人群以及年轻人中也观察到了 AIS。COVID-19 合并 AIS 患者的国立卫生研究院卒中量表(NIHSS)评分高于历史 AIS 患者,大血管闭塞(LVO)的比例约为 64.2%。COVID-19 合并 AIS 患者通常 D-二聚体、纤维蛋白原、C 反应蛋白(CRP)和红细胞沉降率(ESR)水平较高,提示全身炎症反应和高凝状态。COVID-19 合并 AIS 患者的死亡率为 38%,LVO 患者的死亡率更高(45.9%)。与 2020 年和 2019 年同期 COVID-19 阴性 AIS 患者相比,COVID-19 合并 AIS 患者的预后更差。

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