Wednesday, December 16, 2020

Stroke as a Neurological Complication of COVID-19: A Systematic Review and Meta-analysis of Incidence, Outcomes and Predictors

You don't want this happening, so even though they consider it uncommon demand treatment. Don't try to tough it out at home even if they want to treat and release. 

I'm not medically trained but due to the research I'm reading I'm doing heparin.

Why I'm getting heparin.  Heparin binds to cells at a site adjacent to ACE2, the portal for SARS-CoV-2 infection, and "potently" blocks the virus, which could open up therapy options.

Anticoagulation Again Shown to Improve Survival in COVID-19 Patients;-Mortality risk about 50% lower

But this research below suggests not due to bleeding risks. I'll take that risk since I've been on warfarin, aspirin and had Lovenox shots. 

COVID-Related Strokes Especially Severe, Result in Worse Outcomes

The paragraph from there:

"On the other hand, in most patients with COVID-19 associated ischaemic stroke, very early anti-coagulation is probably not warranted as a strategy to prevent inpatient stroke recurrence, as this outcome is too uncommon to justify the increased risk of secondary haemorrhage," according to the group.(So you wait until the clots are severe before you do anti-coagulation. OK, not for me.)

You doctor better know the EXACT PROTOCOL to prevent these complications. 

The latest here:

Stroke as a Neurological Complication of COVID-19: A Systematic Review and Meta-analysis of Incidence, Outcomes and Predictors

Abstract

Introduction

COVID-19 is a multi-system infection which predominantly affects the respiratory system, but also causes systemic inflammation, endothelialitis and thrombosis. The consequences of this include renal dysfunction, hepatitis and stroke. In this systematic review, we aimed to evaluate the epidemiology, clinical course, and outcomes of patients who suffer from stroke as a complication of COVID-19.

Methods

We conducted a systematic review of all studies published between November 1, 2019 and July 8, 2020 which reported on patients who suffered from stroke as a complication of COVID-19.

Results

326 studies were screened, and 30 studies reporting findings from 55,176 patients including 899 with stroke were included. The average age of patients who suffered from stroke as a complication of COVID-19 was 65.5 (Range: 40.4 – 76.4 years). The average incidence of stroke as a complication of COVID-19 was 1.74% (95% CI: 1.09% to 2.51%). The average mortality of stroke in COVID-19 patients was 31.76% (95% CI: 17.77% to 47.31%). These patients also had deranged clinical parameters including deranged coagulation profiles, liver function tests, and full blood counts.

Conclusion

Although stroke is an uncommon complication of COVID-19, when present, it often results in significant morbidity and mortality. In COVID-19 patients, stroke was associated with older age, comorbidities, and severe illness.
Introduction
The coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to cause disruption nine months after it began in Wuhan, China.1
Although COVID-19 predominantly affects the respiratory system, studies in those with severe infections have broadened our understanding of COVID-19 as a multi-system inflammatory disorder with effects on the neurological system as well. Neurological complications associated with COVID-19 include mild complications such as headache and anosmia, and more serious complications such as encephalitis and stroke.2
Stroke appears to be an infrequent complication of COVID-19 but when it occurs can result in significant morbidity and mortality.3
Systematic reviews which consolidate findings of stroke as a complication of COVID-19 are scarce3, 4, 5, 6, examining few primary sources with limited coverage of demographic factors and clinical parameters of patients. To address this gap in literature, we conducted a systematic review to more comprehensively evaluate the epidemiology, clinical course, and outcomes of patients who suffer from stroke as a complication of COVID-19.

No comments:

Post a Comment