Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19?
Introduction: A strong association between stroke and atrial fibrillation (AF) has been demonstrated. Anticoagulation for the prevention of stroke in high-risk patients has the benefit of improving the life expectancy, quality of life, autonomy and social functioning of the patient. The COVID-19 pan...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SMC MEDIA SRL
2020-05-01
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| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/1736 |
| _version_ | 1818291900697804800 |
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| author | Maria Carolina dos Santos Sousa Duarte Seabra Barbara Silva Vitor Fagundes João Rocha Luís Nogueira Mari Mesquita |
| author_facet | Maria Carolina dos Santos Sousa Duarte Seabra Barbara Silva Vitor Fagundes João Rocha Luís Nogueira Mari Mesquita |
| author_sort | Maria Carolina dos Santos Sousa Duarte Seabra |
| collection | DOAJ |
| description | Introduction: A strong association between stroke and atrial fibrillation (AF) has been demonstrated. Anticoagulation for the prevention of stroke in high-risk patients has the benefit of improving the life expectancy, quality of life, autonomy and social functioning of the patient. The COVID-19 pandemic poses challenges for stroke patients because of the association between SARS-CoV-2 infection and thromboembolic risk.
Case description: We describe the case of an 84-year-old female patient admitted due to an embolic stroke and non-anticoagulated AF. Her admission symptoms were sensory-motor aphasia and severe right limb paresis with an NIHSS score of 24. The diagnosis of embolic stroke (namely, total anterior circulation infarct; TACI) was made. Her stroke was extensive so she was not started on anticoagulation. During hospitalization, new embolic events occurred and a concomitant diagnosis of COVID-19 was made with progressive respiratory dysfunction followed by multiorgan failure. The patient died despite appropriate treatment.
Discussion: The prognosis of elderly patients with cardioembolic stroke depends on anticoagulation administration. The NIHSS score on admission of our patient meant anticoagulation therapy was not appropriate. The diagnosis of COVID-19 contributed to the patient’s death. |
| first_indexed | 2024-12-13T02:51:25Z |
| format | Article |
| id | doaj.art-5c1c57dec226421eafef78cdb8c97d2d |
| institution | Directory Open Access Journal |
| issn | 2284-2594 |
| language | English |
| last_indexed | 2024-12-13T02:51:25Z |
| publishDate | 2020-05-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj.art-5c1c57dec226421eafef78cdb8c97d2d2022-12-22T00:02:03ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942020-05-0110.12890/2020_0017361368Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19?Maria Carolina dos Santos Sousa Duarte Seabra0Barbara Silva1Vitor Fagundes2João Rocha3Luís Nogueira4Mari Mesquita5Centro Hospitalar Tâmega e Sousa, Penafiel, PortugalCentro Hospitalar Tâmega e Sousa, Penafiel, PortugalCentro Hospitalar Tâmega e Sousa, Penafiel, PortugalCentro Hospitalar Tâmega e Sousa, Penafiel, PortugalCentro Hospitalar Tâmega e Sousa, Penafiel, PortugalCentro Hospitalar Tâmega e Sousa, Penafiel, PortugalIntroduction: A strong association between stroke and atrial fibrillation (AF) has been demonstrated. Anticoagulation for the prevention of stroke in high-risk patients has the benefit of improving the life expectancy, quality of life, autonomy and social functioning of the patient. The COVID-19 pandemic poses challenges for stroke patients because of the association between SARS-CoV-2 infection and thromboembolic risk. Case description: We describe the case of an 84-year-old female patient admitted due to an embolic stroke and non-anticoagulated AF. Her admission symptoms were sensory-motor aphasia and severe right limb paresis with an NIHSS score of 24. The diagnosis of embolic stroke (namely, total anterior circulation infarct; TACI) was made. Her stroke was extensive so she was not started on anticoagulation. During hospitalization, new embolic events occurred and a concomitant diagnosis of COVID-19 was made with progressive respiratory dysfunction followed by multiorgan failure. The patient died despite appropriate treatment. Discussion: The prognosis of elderly patients with cardioembolic stroke depends on anticoagulation administration. The NIHSS score on admission of our patient meant anticoagulation therapy was not appropriate. The diagnosis of COVID-19 contributed to the patient’s death.https://www.ejcrim.com/index.php/EJCRIM/article/view/1736embolismstrokecovid-19atrial fibrillation |
| spellingShingle | Maria Carolina dos Santos Sousa Duarte Seabra Barbara Silva Vitor Fagundes João Rocha Luís Nogueira Mari Mesquita Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19? European Journal of Case Reports in Internal Medicine embolism stroke covid-19 atrial fibrillation |
| title | Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19? |
| title_full | Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19? |
| title_fullStr | Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19? |
| title_full_unstemmed | Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19? |
| title_short | Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19? |
| title_sort | should the management of embolic stroke in the elderly be changed if they also have covid 19 |
| topic | embolism stroke covid-19 atrial fibrillation |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/1736 |
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