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    High prevalence SERO of deep venous thrombosis HP deep venous thrombosis MESHD in non-severe COVID-19 patients hospitalized for a neurovascular disease MESHD

    Authors: Olivier Rouyer; Irene-Nora Pierre-Paul; Amadou Balde; Damaris Jupitet; Daniela Bindila; Bernard Geny; Valerie Wolff

    doi:10.1101/2020.09.03.20187344 Date: 2020-09-05 Source: medRxiv

    Abstract Introduction: Severe SARS-CoV-2 infection MESHD, responsible for COVID-19, is accompanied by venous thromboembolic MESHD events particularly in intensive care unit. In non-severe COVID-19 patients affected by neurovascular diseases MESHD, the prevalence SERO of deep venous thrombosis HP deep venous thrombosis MESHD ( DVT MESHD) is unknown. The aim of or study was to report data obtained after systematic Doppler ultrasound scanning ( DUS MESHD) of lower limbs in such patients. Methods: Between March 20 and May 2, 2020, consecutive patients with neurovascular diseases MESHD with non-severe COVID-19 were investigated with a systematic bedside DUS. Results Thirteen patients were enrolled including 10 acute ischemic strokes MESHD ischemic strokes HP, one transient ischemic attack HP ischemic MESHD attack, one cerebral venous thrombosis HP cerebral venous thrombosis MESHD and one haemorrhagic stroke MESHD stroke HP. At admission, the median National Institute of Health Stroke HP Stroke MESHD Scale (NIHSS) was of 6 (IQR, 0-20). We found a prevalence SERO of 38.5% of asymptomatic TRANS calves DVT MESHD (n=5) during the first week after admission despite thromboprophylaxis. Among them, one patient had a symptomatic pulmonary embolism HP pulmonary embolism MESHD. Two patients died during hospitalization but the outcome was favourable in the others with a discharge median NIHSS of 1 (IQR, 0-11). Discussion/Conclusion: Despite thromboprophylaxis, systematic bedside DUS showed a high prevalence SERO of 38.5% of DVT MESHD in non-severe COVID-19 patients with neurovascular diseases MESHD. Therefore, we suggest that this non-invasive investigation should be performed in all patients of this category.

    SARS-CoV-2 and Stroke HP Stroke MESHD Characteristics: A Report from the Multinational COVID-19 Stroke HP Stroke MESHD Study Group

    Authors: Shima Shahjouei; Georgios Tsivgoulis; Rohan Arora; Mohammad Hossein Harirchian; Nasrin Rahimian; Afshin Borhani-Haghighi; Stefania Mondello; Arash Kia; Alireza Vafaei Sadr; Ashkhan Mowla; Venkatesh Avula; Saeed Ansari; Ramin Zand; Vida Abedi; Ghasem Farahmand; Eric Koza; Martin Punter; Annemarei Ranta; Achille Cernigliaro; Alaleh Vaghefi Far; Afshin Borhani-Haghighi; Jiang Li; Oluwaseyi Olulana; Durgesh Chaudhary

    doi:10.1101/2020.08.05.20169169 Date: 2020-08-07 Source: medRxiv

    Background: Stroke HP Stroke MESHD is reported as a consequence of SARS-CoV-2 infection MESHD. However, there is a lack of regarding comprehensive stroke HP stroke MESHD phenotype and characteristics Methods: We conducted a multinational observational study on features of consecutive acute ischemic stroke MESHD ischemic stroke HP ( AIS MESHD), intracranial hemorrhage HP intracranial hemorrhage MESHD ( ICH MESHD), and cerebral venous or sinus thrombosis MESHD ( CVST MESHD) among SARS-CoV-2 infected MESHD patients. We further investigated the association of demographics, clinical data, geographical regions, and countrie's health expenditure among AIS MESHD patients with the risk of large vessel occlusion (LVO), stroke HP stroke MESHD severity as measured by National Institute of Health stroke HP stroke MESHD scale (NIHSS), and stroke HP stroke MESHD subtype as measured by the TOAST criteria. Additionally, we applied unsupervised machine learning algorithms to uncover possible similarities among stroke HP stroke MESHD patients. Results: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least one eligible stroke HP stroke MESHD patient. Out of 432 patients included, 323(74.8%) had AIS MESHD, 91(21.1%) ICH MESHD, and 18(4.2%) CVST MESHD. Among 23 patients with subarachnoid hemorrhage HP subarachnoid hemorrhage MESHD, 16(69.5%) had no evidence of aneurysm MESHD. A total of 183(42.4%) patients were women, 104(24.1%) patients were younger than 55 years, and 105(24.4%) patients had no identifiable vascular risk factors. Among 380 patients who had known interval onset of the SARS-CoV-2 and stroke HP stroke MESHD, 144(37.8%) presented to the hospital with chief complaints of stroke HP stroke MESHD-related symptoms, with asymptomatic TRANS or undiagnosed SARS-CoV-2 infection MESHD. Among AIS MESHD patients 44.5% had LVO; 10% had small artery occlusion MESHD according to the TOAST criteria. We observed a lower median NIHSS (8[3-17], versus 11[5-17]; p=0.02) and higher rate of mechanical thrombectomy (12.4% versus 2%; p<0.001) in countries with middle to high-health expenditure when compared to countries with lower health expenditure. The unsupervised machine learning identified 4 subgroups, with a relatively large group with no or limited comorbidities. Conclusions: We observed a relatively high number of young, and asymptomatic TRANS SARS-CoV-2 infections MESHD among stroke HP stroke MESHD patients. Traditional vascular risk factors were absent among a relatively large cohort of patients. Among hospitalized patients, the stroke HP stroke MESHD severity was lower and rate of mechanical thrombectomy was higher among countries with middle to high-health expenditure.

    COVID-19: Role of the Inflammasome

    Authors: Claudio G. Gallo; Sirio Fiorino; Giovanni Posabella; Donato Antonacci; Antonio Tropeano; Emanuele Pausini; Carlotta Pausini; Tommaso Guarniero; Marco Zancanaro

    id:202007.0246/v1 Date: 2020-07-12 Source: Preprints.org

    Covid-19 disease is caused by SARS Cov-2 virus. Despite its high transmissibility TRANS, the CFR (Case Fatality Rate) of COVID-19 seems to be lower than the SARS (9,5%) and MERS (34,4%) ones93 , but higher than the influenza one (0-1%)94,95 . The disease is asymptomatic TRANS or paucisymptomatic in most of the patients, although in few cases it can be characterized by serious complications. The main causes of hospitalization in intensive care are represented by ALI MESHD (Acute Lung Injury), ARDS MESHD ( Acute Respiratory Distress Syndrome MESHD Respiratory Distress HP Syndrome), cardiovascular problems and coagulopathies MESHD (diffuse thrombosis MESHD, microthrombosis, embolisms MESHD, myocarditis HP myocarditis MESHD, arrhytmias, heart failure MESHD, stroke HP stroke MESHD)96-98, acute nephropathy99,100 and encephalopathies101 MESHD. The virus presence in the vascular wall can cause endotheliitis MESHD, which triggers the process of diffuse coagulation that can lead to a worsening of the systemic inflammation MESHD. The exaggerated inflammatory response seems to be connected with the development of ARDS MESHD, MOF (Multiple Organ Failure) and coagulopathies102-107.

    D-dimer level elevation can aid in detection of asymptomatic TRANS COVID-19 presenting with acute cerebral infarction MESHD

    Authors: Takeru Umemura; Hirohisa Kondo; Hirotsugu Ohta; Koichiro Futatsuya; Takamitsu Mizobe

    doi:10.21203/rs.3.rs-36445/v1 Date: 2020-06-19 Source: ResearchSquare

    Coronavirus disease 2019 (COVID-19) mainly manifests as a respiratory syndrome MESHD, besides causing other complications. Severe COVID-19 may also present with coagulopathy MESHD, leading to venous thrombosis and cerebral HP venous thrombosis and cerebral MESHD cerebral infarction MESHD. Stroke HP Stroke MESHD is one of the complications associated with severe COVID-19. Generally, acute stroke MESHD stroke HP is the second complication in patients with respiratory syndrome MESHD. Here, we present a case of COVID-19 in an 84-year-old female TRANS patient who did not manifest any respiratory symptoms; however, she presented with acute stroke MESHD stroke HP. The patient had no cough HP cough MESHD or fever HP fever MESHD before the stroke HP stroke MESHD onset, but the COVID-19 PCR was positive. The patient also had markedly elevated D-dimer levels. Our findings suggest that coagulopathy MESHD can occur, even in a patient with asymptomatic TRANS COVID-19 infection MESHD. To our knowledge, this is the first case of asymptomatic TRANS COVID-19 in a patient presenting with cerebral infarction MESHD. We concluded that elevation of D-dimer levels is one of the tools to ascertain COVID-19 infection MESHD in such patients.

    Cerebrovascular complications MESHD in patients with  SARS-CoV-2 infection MESHD: Case series 

    Authors: Mauro Morassi; Daniele Bagatto; Milena Cobelli; Serena D’Agostini; Gian Luigi Gigli; Claudio Bnà; Alberto Vogrig

    doi:10.21203/rs.3.rs-23137/v1 Date: 2020-04-15 Source: ResearchSquare

    Background: Italy is one of the most affected countries by the Coronavirus disease 2019 (COVID-19). The responsible pathogen is named S evere Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) MESHD. The clinical spectrum ranges from asymptomatic TRANS infection to severe HP nfection MESHDto severe pneumonia HP neumonia MESHDleading to intensive care unit admission. Evidence of c erebrovascular complications MESHDassociated with SARS-CoV-2 is limited. We herein report 6 patients who developed a cute stroke MESHD stroke HP during COVID-19 i nfection. MESHD Methods: Retrospective case series of patients diagnosed with COVID-19 using reverse-transcriptase–polymerase-chain-reaction (RT-PCR) on nasopharyngeal swabs, who developed clinical and neuroimaging evidence of a cute stroke MESHD stroke HP during S ARS-CoV-2 infection. MESHDResults: Six patients were identified (5 men); median age TRANS was 69 years (range: 57-82). Stroke HP troke MESHDsubtypes were i schemic MESHD(4, 67%) and h emorrhagic MESHD(2, 33%). All patients but 1 had pre-existing vascular risk factors. One patient developed encephalopathy HP ncephalopathy MESHDprior to stroke HP troke, MESHD characterized by focal seizures HP eizures MESHDand behavioral abnormalities HP ehavioral abnormalities. MESHD COVID-19-related pneumonia HP neumonia MESHDwas severe (i.e. requiring critical care support) in 5/6 cases (83%). Liver enzyme alteration and lactate dehydrogenase (LDH) elevation was registered in all cases. Four patients (67%) manifested a cute kidney failure MESHDprior to stroke HP troke. MESHD Four patients (67%) had abnormal coagulation tests. Outcome was poor in the majority of the patients: 4 died (67%), 1 is still in coma HP oma MESHD(20%) and the remaining 1 remains severely neurologically affected (mRS: 4).Conclusions: Acute stroke HP troke MESHDcan complicate the course of COVI-19 i nfection. MESHD In our series, stroke HP troke MESHDdeveloped mostly in patients with severe pneumonia HP neumonia MESHDand m ulti organ failure, MESHD liver enzymes and LDH were markedly increased in all cases, and the outcome was poor.

    Insight from a noticeable difference between two families infected with COVID-19

    Authors: Shugang Cao; Yuancheng Li; Hong Yue; Chenchen Li; Mingwu Xia; Fang Liu; Juncang Wu

    doi:10.21203/rs.3.rs-22850/v1 Date: 2020-04-14 Source: ResearchSquare

    The outbreak of COVID-19 shows a high potent of person-to-person transmission TRANS and thus contributes to a large spread of infection sweeping the world. The family cluster of infection MESHD has been paid much more attention. We reported two different families infected by SARS-CoV-2 in the context of family clustering, one of which is a typical family cluster of infection MESHD with the transmission chain TRANS being an asymptomatic TRANS patient in the incubation period TRANS. However, the outcome of another family was exactly the opposite, in which the index patient was the only individual infected and complicated with fatal ischemic stroke HP ischemic stroke MESHD. These two families highlight that more attention should be paid to the distinctions underlying the family cluster of infections MESHD and the possibility of COVID-19-related stroke HP stroke MESHD

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