Author: Carneiro, Thiago; Dashkoff, Jonathan; Leung, Lester Y.; Nobleza, Christa O'Hana S.; Marulanda-Londono, Erika; Hathidara, Mausaminben; Koch, Sebastian; Sur, Nicole; Boske, Alexandra; Voetsch, Barbara; Nour, Hassan Aboul; Miller, Daniel J; Daneshmand, Ali; Shulman, Julie; Curiale, Gioacchino; Greer, David M.; Romero, Jose Rafael; Anand, Pria; Cervantes-Arslanian, Anna M.
Title: Intravenous tPA for Acute Ischemic Stroke in Patients with COVID-19 Cord-id: 862kffnb Document date: 2020_7_27
ID: 862kffnb
Snippet: 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 identifie
Document: 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.
Search related documents:
Co phrase search for related documents- acute ischemic stroke and admission time: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20
- acute ischemic stroke patient and admission time: 1
- acute ischemic stroke treatment and admission time: 1, 2, 3, 4, 5, 6
- acute patient ischemic stroke and admission time: 1
- acute respiratory distress syndrome and additional evidence: 1, 2, 3, 4, 5, 6, 7
- acute respiratory distress syndrome and admission time: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25
- acute respiratory distress syndrome and low efficacy: 1, 2, 3, 4, 5
- acute stroke and additional evidence: 1, 2
- acute stroke and admission time: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25
- acute stroke and low efficacy: 1
- acute stroke management and admission time: 1
- additional evidence and admission time: 1
- additional evidence and low efficacy: 1
- admission time and low efficacy: 1
Co phrase search for related documents, hyperlinks ordered by date