Acute ischemic stroke in COVID-19: a case report


  • Mamatha Tittamegalapalya Ramalingaiah Department of Medicine, ESIC and PGIMSR, Bengaluru, Karnataka, India
  • Jeetendra Kumar Jogihalli Mood Department of Medicine, ESIC and PGIMSR, Bengaluru, Karnataka, India
  • Vinutha Bagalur Srinivas Murthy Department of Medicine, ESIC and PGIMSR, Bengaluru, Karnataka, India
  • Virender Singh Department of Medicine, ESIC and PGIMSR, Bengaluru, Karnataka, India



Stroke, COVID-19, D-dimer, CRP


Corona virus disease (COVID-19) is an infectious disease caused by SARS-CoV-2 virus. It predominantly affects respiratory system causing fever, cough, and breathlessness. But it can also affect central nervous system. Clinicians must adopt methodical approach in investigating a patient with neurological manifestation. Early detection and treatment is required for neurological disease of COVID-19 to reduce post COVID neurological sequel.



Mao L, Jin H, Wang M, Hu Y, Chen S, He Q. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;45(35):25-9.

Qureshi AI, Abd-Allah F, Alsenani F, Aytac E, Borhani-Haghighi A, Ciccone A, et al. Management of acute ischemic stroke in patients with COVID-19 infection: Report of an international panel. Int J Stroke. 2020;2020;174.

Yaghi S, Ishida K, Torres J, Mac Grory B, Raz E, Humbert K, et al. SARS2-CoV-2 and stroke in a New York healthcare system. Stroke. 2020;50(6);2120-8.

Qin C, Zhou L, Hu Z, Yang S, Zhang S, Chen M, et al. Clinical characteristics and outcomes of COVID-19 patients with a history of stroke in Wuhan, China. Stroke. 2020;51(7):2219-23.

Wijeratne T, Sales C, Karimi L, Crewther SG. Acute ischemic stroke in COVID-19: a case-based systematic review. Front Neurol. 2020;11:1031.

Mohamed IZB, Balson L, Madathil S. Massive bilateral stroke in a COVID-19 patient. BMJ Case Rep. 2020;13:e236-54.

Sriwastava S, Srivastava S, Kataria S, Melnic V, Adcock A, Sheikh Z. Neurological complications of COVID-19: a systematic review of literature. Front Neurol. 2020;10:212-6.

Nassir CMN, Hashim S, Wong KK, Abdul Halim S, Idris NS, Jayabalan N, et al. COVID-19 infection and circulating microparticles-reviewing evidence as microthrombogenic risk factor for cerebral small vessel disease. Mol Neurobiol. 2021;26:1-28.

D’Anna L, Kwan J, Brown Z. Characteristics and clinical course of Covid-19 patients admitted with acute stroke. J Neurol. 2020;10:1007-12.

Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol. 2020;45:52-9.

Zurrú MC, Alonzo C, Brescacín L. Recent respiratory infection predicts atherothrombotic stroke: case-control study in a Buenos Aires healthcare system. Stroke. 2009;40:1986-90.

Cowan LT, Lutsey PL, Pankow JS. Inpatient and outpatient infection as a trigger of cardiovascular disease: the ARIC study. J Am Heart Assoc. 2018;7: e9683-9.

Grau AJ, Buggle F, Becher H. Recent bacterial and viral infection is a risk factor for cerebrovascular ischemia: clinical and biochemical studies. Neurol. 1998;50:196-203.

Bova IY, Bornstein NM, Korczyn AD. Acute infection as a risk factor for ischemic stroke. Stroke. 1996;27:2204-6.

Lindsberg PJ, Grau AJ. Inflammation and infections as risk factors for ischemic stroke. Stroke. 2003;34: 2518-32.

Becher H, Grau A, Steindorf K. Previous infection and other risk factors for acute cerebrovascular ischaemia: attributable risks and the characterisation of high-risk groups. J Epidemiol Biostat. 2000;5:277-83.

Escalard S, Maïer B, Redjem H, Delvoye F, Hébert S, Smajda S, et al. Treatment of acute ischemic stroke due to large vessel occlusion with COVID-19: experience from Paris. Stroke. 2020;29:120-9.

Oxley TJ, Mocco J, Majidi S, Kellner CP, Shoirah H, Singh IP, et al. Large-vessel stroke as a presenting feature of Covid-19 in the young. N Engl J Med. 2020;382:e60.






Case Reports