Acute Ischemic Stroke as Presenting Symptoms in COVID-19 Patients- Case Series

Deep Kamal, Vaidehi Thakur, Tarun, Malhotra, Aditya Gupta, M. Kashiviswanathan


 The Coronavirus disease-2019 (COVID-19) pandemic which started in December 2019 affected almost the entire globe. India is witnessing the second wave of pandemic from mid-February 2021 wherein cases of COVID-19 are rising sharply. Apart from constitutional symptoms, other common symptoms involve respiratory and gastrointestinal systems. Here, we present case series of three COVID-19 positive patients, who primarily reported to hospital with neurological symptoms of acute stroke. Polymerase chain reaction confirmation of COVID-19 infections was done. All of them had radiological evidence of acute ischemic stroke and lung involvement due to COVID-19 infection. We have also illustrated the clinical manifestation, radiological findings, and the clinical course of all these patients. COVID-19 is a pro-inflammatory, hypercoagulable state, with increased risk of arterial and venous thrombosis. This leads to acute ischemic cerebrovascular accident. In small set of patients though symptomatic for COVID-19, neurological symptoms could be the presenting symptom for seeking medical aid. It is, therefore, suggested to observe any neurological symptoms suggestive of stroke in the early days of COVID-19 infection.

Key words: Coronavirus disease-2019 infection, Hypercoagulable state, Ischemic stroke

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