Intravenous tPA for Acute Ischemic Stroke in Patients with COVID-19

التفاصيل البيبلوغرافية
العنوان: Intravenous tPA for Acute Ischemic Stroke in Patients with COVID-19
المؤلفون: Jonathan Dashkoff, Lester Y. Leung, Barbara Voetsch, Anna M. Cervantes-Arslanian, Gioacchino Curiale, Alexandra Boske, Pria Anand, Hassan Aboul Nour, Julie G. Shulman, Ali Daneshmand, Thiago Carneiro, Erika Marulanda-Londoño, Sebastian Koch, David M. Greer, Jose R. Romero, Christa O'Hana S. Nobleza, Mausaminben Hathidara, Daniel Miller, Nicole B. Sur
المصدر: Journal of Stroke and Cerebrovascular Diseases
Web of Science
بيانات النشر: Elsevier BV, 2020.
سنة النشر: 2020
مصطلحات موضوعية: thrombolysis, medicine.medical_treatment, Clinical Neurology, Disease, Tissue plasminogen activator, Article, IV tPA, Brain ischemia, 03 medical and health sciences, 0302 clinical medicine, ischemic stroke, medicine, Young adult, Stroke, business.industry, Rehabilitation, COVID-19, Thrombolysis, medicine.disease, Pneumonia, Anesthesia, Surgery, Neurology (clinical), business, Cardiology and Cardiovascular Medicine, 030217 neurology & neurosurgery, Fibrinolytic agent, medicine.drug
الوصف: Background/Purpose: Coronavirus disease 2019 (COVID-19) is associated with increased risk of acute ischemic stroke (AIS), however, there is a paucity of data regarding outcomes after administration of intravenous tissue plasminogen activator (IV tPA) for stroke in patients with COVID-19. Methods: We present a multicenter case series from 9 centers in the United States of patients with acute neurological deficits consistent with AIS and COVID-19 who were treated with IV tPA. Results: We identified 13 patients (mean age 62 (±9.8) years, 9 (69.2%) male). All received IV tPA and 3 cases also underwent mechanical thrombectomy. All patients had systemic symptoms consistent with COVID-19 at the time of admission: fever (5 patients), cough (7 patients), and dyspnea (8 patients). The median admission NIH stroke scale (NIHSS) score was 14.5 (range 3–26) and most patients (61.5%) improved at follow up (median NIHSS score 7.5, range 0–25). No systemic or symptomatic intracranial hemorrhages were seen. Stroke mechanisms included cardioembolic (3 patients), large artery atherosclerosis (2 patients), small vessel disease (1 patient), embolic stroke of undetermined source (3 patients), and cryptogenic with incomplete investigation (1 patient). Three patients were determined to have transient ischemic attacks or aborted strokes. Two out of 12 (16.6%) patients had elevated fibrinogen levels on admission (mean 262.2 ± 87.5 mg/dl), and 7 out of 11 (63.6%) patients had an elevated D-dimer level (mean 4284.6 ±3368.9 ng/ml). Conclusions: IV tPA may be safe and efficacious in COVID-19, but larger studies are needed to validate these results.
اللغة: English
تدمد: 1052-3057
DOI: 10.1016/j.jstrokecerebrovasdis.2020.105201
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bf175dcfbb4d828a82830ed91eb4fc42
Rights: OPEN
رقم الانضمام: edsair.doi.dedup.....bf175dcfbb4d828a82830ed91eb4fc42
قاعدة البيانات: OpenAIRE
الوصف
تدمد:10523057
DOI:10.1016/j.jstrokecerebrovasdis.2020.105201