Pathomechanisms and Treatment Implications for Stroke in COVID-19: A Review of the Literature.
Pathomechanisms and Treatment Implications for Stroke in COVID-19: A Review of the Literature.
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DOI：
10.3390/life12020207
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发表时间：
2022-01-29
期刊：
影响因子：
--
通讯作者：
Desai M
中科院分区：
文献类型：
--
作者：
Stamm B;Huang D;Royan R;Lee J;Marquez J;Desai M
在全球COVID-19大流行期间，COVID-19患者的卒中受到越来越多的关注，这可能是由于当这两种疾病同时发生时可能导致严重的残疾和死亡。我们回顾了现有文献，发现COVID-19相关缺血性卒中的潜在病理机制大致分为以下三类：血管炎、内皮炎和内皮功能障碍;高凝状态;继发于心功能障碍的心源性栓塞。关于中风和COVID-19之间是否存在因果关系，一直存在大量争论。然而，在与非COVID-19卒中的汇总分析比较中出现的COVID-19相关卒中的独特表型（多支血管区域梗死、大血管闭塞比例较高和隐源性卒中机制）令人信服。此外，在这篇文章中，我们回顾了各种治疗方法，因为它们涉及到拟议的病理机制。最后，我们简要介绍了供应商和卫生系统面临的后勤挑战，如治疗延迟;所采用的创新方法，包括远程中风的作用;以及COVID-19相关中风研究和医疗保健提供的未来方向。
Stroke in patients with COVID-19 has received increasing attention throughout the global COVID-19 pandemic, perhaps due to the substantial disability and mortality that can result when the two conditions co-occur. We reviewed the existing literature and found that the proposed pathomechanism underlying COVID-19-associated ischemic stroke is broadly divided into the following three categories: vasculitis, endothelialitis, and endothelial dysfunction; hypercoagulable state; and cardioembolism secondary to cardiac dysfunction. There has been substantial debate as to whether there is a causal link between stroke and COVID-19. However, the distinct phenotype of COVID-19-associated strokes, with multivessel territory infarcts, higher proportion of large vessel occlusions, and cryptogenic stroke mechanism, that emerged in pooled analytic comparisons with non-COVID-19 strokes is compelling. Further, in this article, we review the various treatment approaches that have emerged as they relate to the proposed pathomechanisms. Finally, we briefly cover the logistical challenges, such as delays in treatment, faced by providers and health systems; the innovative approaches utilized, including the role of tele-stroke; and the future directions in COVID-19-associated stroke research and healthcare delivery.
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DOI：
10.1016/j.jstrokecerebrovasdis.2020.105542
发表时间：
2021-03
期刊：
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
影响因子：
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作者：
Batra A;Clark JR;LaHaye K;Shlobin NA;Hoffman SC;Orban ZS;Colton K;Dematte JE;Sorond FA;Koralnik IJ;Liotta EM
通讯作者：
Liotta EM
DOI：
10.1007/s10072-020-04870-z
发表时间：
2021-01
期刊：
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
影响因子：
--
作者：
Cheruiyot I;Sehmi P;Ominde B;Bundi P;Mislani M;Ngure B;Olabu B;Ogeng'o JA
通讯作者：
Ogeng'o JA
影响因子：
15.1
作者：
Benger, Matthew;Williams, Owain;Sztriha, Laszlo
通讯作者：
Sztriha, Laszlo
DOI：
10.1001/jamahealthforum.2020.1463
发表时间：
2020-12-01
期刊：
JAMA health forum
影响因子：
--
作者：
Findling, Mary G;Blendon, Robert J;Benson, John M
通讯作者：
Benson, John M
影响因子：
--
作者：
Daly SR;Nguyen AV;Zhang Y;Feng D;Huang JH
通讯作者：
Huang JH