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:
    Duarte Seabra, M. C., Silva, B., Fagundes, V., Rocha, J., Nogueira, L., & Mesquita, M. (2020). 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, 7(6). https://doi.org/https://doi.org/10.12890/2020_001736