Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19?

  • Maria Carolina dos Santos Sousa Duarte Seabra Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
  • Barbara Silva Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
  • Vitor Fagundes Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
  • João Rocha Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
  • Luís Nogueira Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal
  • Mari Mesquita Centro Hospitalar Tâmega e Sousa, Penafiel, Portugal

Keywords

Embolism, stroke, COVID-19, atrial fibrillation

Abstract

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.

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  • Published: 2020-05-25

    Issue: Vol 7 No 6 (view)

    Section: Articles

    How to cite:
    1.
    Duarte Seabra MC dos SS, Silva B, Fagundes V, Rocha J, Nogueira L, Mesquita M. Should the Management of Embolic Stroke in the Elderly Be Changed if They Also Have COVID-19?. EJCRIM [Internet]. 2020May25 [cited 2020Sep.19];7(6). Available from: https://ejcrim.com/index.php/EJCRIM/article/view/1736