Abstract
The aim of this work is to provide an overview of the relationship between COVID-19 and stroke. The work deals with the risk of stroke and its mechanisms in patients with COVID-19, as well as the prognosis, impact on the organization of care and the treatment of stroke itself due to the COVID-19 pandemic.
The COVID-19 pandemic has led to a reduction in acute care for stroke patients in a number of countries, but in the Czech Republic there was no significant deterioration in the provision of this care during the spring wave in 2020. The incidence of stroke in patients with COVID-19 ranges from 0.9 to 6%, but may be higher.
Patients with stroke should be tested for COVID-19, especially if they do not have typical cardiovascular risk factors. The clinical manifestation of a stroke in patients with COVID-19 is moderate to severe, with a high percentage of these patients having large artery occlusion.
Most patients with COVID-19 and stroke are older and have typical cardiovascular risk factors, but stroke may also occur in young patients without risk factors. Stroke develops on average within 11 days of the development of COVID-19 symptoms (severe COVID-19 infection may be complicated by an early cytokine storm, followed by a prothrombotic condition and frequent venous and arterial thromboembolic complications), but stroke may develop also in the early phase of infection.
Patients with COVID-19 and stroke have a worse clinical outcome and higher mortality than patients with stroke without COVID-19. COVID-19 stroke patients should receive standard treatment.
Prophylactic or therapeutic anticoagulation could also be beneficial.