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Revista Española de Anestesiología y Reanimación (English Edition) Ischemic-hemorrhagic stroke in patients with Covid-19
Journal Information
Vol. 67. Issue 9.
Pages 487-536 (November 2020)
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474
Vol. 67. Issue 9.
Pages 487-536 (November 2020)
Case report

Ischemic-hemorrhagic stroke in patients with Covid-19

Afectación cerebrovascular isquémico-hemorrágica en pacientes con covid-19
Visits
474
N. Azpaiazu Landa
Corresponding author
azpilandan@gmail.com

Corresponding author.
, C. Velasco Oficialdegui, K. Intxaurraga Fernández, I. Gonzalez Larrabe, S. Riaño Onaindia, S. Telletxea Benguria
Servicio de Anestesia y Reanimación, Hospital de Galdakao, Galdakao, Bizkaia, Spain
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Abstract

Coronavirus associated severe acute respiratory syndrome (SARS-CoV-2) causes a worldwide syndrome called Covid-19 that has caused 5,940,441 infections and 362,813 deaths until May 2020. In moderate and severe stages of the infection a generalized swelling, cytokine storm and an increment of the heart damage biomarkers occur. In addition, a relation between Covid-19 and neurological symptoms have been suggested. The results of autopsies suggest thrombotic microangiopathy in multiple organs. We present 2 cases of patients infected with severe Covid-19 that were hospitalized in the Reanimation Unit that presented cerebrovascular symptoms and died afterwards. A high dose prophylaxis with antithrombotic medication is recommended in patients affected by moderate to severe Covid-19.

Keywords:
Stroke
Anticoagulation
Thrombotic microangiopathy
Cardiovascular affectation
Thrombosis
Neurology
Covid-19
SARS-CoV-2
Resumen

La infección por el coronavirus asociada al síndrome de distrés respiratorio agudo severo (SARS-CoV-2) produce un síndrome clínico denominado mundialmente covid-19 que ha generado 5.940.441 infectados y 362.813 muertes hasta mayo de 20201. En estadios moderados y severos de la infección se produce una reacción sistémica del organismo caracterizada por la hiperinflamación, tormenta de citocinas y elevación de biomarcadores de daño miocárdico. Además, se ha sugerido la relación entre covid-19 y manifestaciones neurológicas. Recientes autopsias sugieren microangiopatía trombótica en múltiples órganos. Presentamos la descripción de 2 casos de pacientes con covid-19 severo, ingresados en Reanimación, que presentaron afectación cerebrovascular y fallecieron posteriormente. Se recomienda estrictamente la aplicación de profilaxis farmacológica antitrombótica en los pacientes afectados por covid-19 ingresados en cuidados críticos y se sugiere administrar dosis profilácticas por encima de la media.

Palabras clave:
Accidente cerebrovascular
Anticoagulación
Microangiopatía trombótica
Afectación cardiovascular
Trombosis
Neurología
Covid-19
SARS-CoV-2

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