Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Trends Neurosci. 2021 Jul;44(7):527-537. doi: 10.1016/j.tins.2021.03.005. Epub 2021 Apr 8.
Prior to COVID-19, only two human-tropic coronaviruses resulted in epidemics and cerebrovascular disease was rarely reported. Evidence now suggests that 1-6% of hospitalized COVID-19 patients develop stroke. According to some reports, stroke risk is more than sevenfold greater in patients with COVID-19 than influenza. Concerningly, outcomes of COVID-19-related stroke are often worse than in stroke patients without COVID-19 from the same cohorts. In this review, we highlight the emerging association between COVID-19 and stroke and discuss putative pathogenetic mechanisms. Etiology of stroke in COVID-19 patients is likely multifactorial, related to coagulopathy, inflammation, platelet activation, and alterations to the vascular endothelium. Significant work remains to be done to better understand the pathogenesis of COVID-19-related stroke and for designing optimal primary and secondary prevention strategies.
在 COVID-19 之前，只有两种人类冠状病毒导致了流行病，而脑血管疾病很少见有报道。现在有证据表明，住院的 COVID-19 患者中有 1-6%会发生中风。根据一些报告，COVID-19 患者的中风风险比流感患者高七倍以上。令人担忧的是，来自同一队列的 COVID-19 相关中风患者的预后通常比没有 COVID-19 的中风患者更差。在这篇综述中，我们强调了 COVID-19 与中风之间的新关联，并讨论了可能的发病机制。COVID-19 患者中风的病因可能是多因素的，与凝血功能障碍、炎症、血小板激活和血管内皮改变有关。为了更好地了解 COVID-19 相关中风的发病机制并制定最佳的一级和二级预防策略，还有大量工作要做。
