Brainstem stroke: a fatal thromboembolic event after new onset atrial fibrillation during covid-19 infection: A case report and literature review

Bouchlarhem, Amine; Haddar, Leila; Nasri, Siham; Onci-Es-Saad; Kallel, Ossema; Bkiyar, Houssam; Ismaili, Nabila; Skiker, Imane; Housni, Brahim

Introduction: COVID-19 disease is a serious pandemic that put the world on an exceptional sanitary alert. It is a multifaceted disease, since it can affect the lung, the cardiovascular system and the central nervous system at the same time. Case report: A 66-year-old man, diabetic, hypertensive, admitted to the emergency room for medical management of acute dyspnea, diagnosed with COVID-19 infection. The evolution is marked by respiratory distress as well as new onset atrial fibrillation and a severe ischemic stroke of the brainstem. Discussion: COVID-19 disease is associated with very serious thromboembolic complications of high incidence, and this is explained by the coagulopathy secondary to the alteration of the microcirculation after the hyper-inflammatory state. Ischemic stroke is one of these complications. The occurrence of new onset atrial fibrillation during COVID-19 infection makes the incidence of ischemic stroke very high and the prognosis more severe. The treatment is mainly based on antithrombotic therapy. Conclusion: Thromboembolic complications remain a real problem to manage in COVID-19 patients given the several mechanisms that promote this situation.