Background

Coronavirus infection is a novel respiratory disease affecting people across the world. Although the majority of patients present with fever, dyspnea, cough, or myalgia, various signs and symptoms have been reported for this disease. Recently, neurological symptoms have been noticed in patients with COVID-19 with unknown etiology. However, the occurrence of strokes in young and middle aged patients with COVID-19 is not fully explained.

Methods

In this series, six patients younger than 55 years of age with diagnosis of stroke and a confirmed diagnosis of COVID-19 were evaluated for symptoms, lab data, imaging findings, and outcomes from March 2020 to the end of April 2020 from all stroke cases in a tertiary academic hospital. Patients older than 55 and all others who had evidence of cardiac abnormalities (arrhythmia/valvular) were excluded.

Results

Fever, myalgia, cough, and dyspnea were the most common clinical symptoms noted in 66.66% (4/6), 66.66% (4/6), 50% (3/6), and 50% (3/6) of the patients, respectively. The mean ± standard deviation (SD) of National Institutes of Health Stroke Scale (NIHSS) for the patient was 10.16 ± 7.13 (ranged 5–24). The most involved area was middle cerebral artery (MCA) (five in MCA versus one in basal ganglia) and the majority of our patients had a low lung involvement score (mean ± SD: 13.16 ± 6.49 out of 24). Finally, one patient was deceased and rest discharged.

Conclusion

Stroke may be unrelated to age and the extent of lung involvement. However, different factors may play roles in co-occurrence of stroke and COVID-19 and its outcome. Future studies with long-term follow-up and more cases are needed to assess prognostic factors.

中文翻译：

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55 岁以下成人与 COVID-19 相关的中风：病例系列。

背景

冠状病毒感染是一种影响世界各地人们的新型呼吸道疾病。尽管大多数患者出现发热、呼吸困难、咳嗽或肌痛，但已报告了该病的各种体征和症状。最近，在病因不明的 COVID-19 患者中发现了神经系统症状。然而，尚未完全解释 COVID-19 青年和中年患者中风的发生。

方法

在该系列中，对 2020 年 3 月至 2020 年 4 月底所有中风病例的 6 名 55 岁以下确诊为中风并确诊为 COVID-19 的患者的症状、实验室数据、影像学检查结果和结果进行了评估在三级学术医院。55 岁以上的患者和所有其他有心脏异常（心律失常/瓣膜）证据的患者被排除在外。

结果

发热、肌痛、咳嗽和呼吸困难是 66.66% (4/6)、66.66% (4/6)、50% (3/6) 和 50% (3/6) 的患者最常见的临床症状。患者，分别。美国国立卫生研究院卒中量表 (NIHSS) 的平均值 ± 标准差 (SD) 为 10.16 ± 7.13（范围 5-24）。受累最严重的区域是大脑中动脉 (MCA)（MCA 5 个，基底节 1 个），我们的大多数患者肺部受累评分较低（平均 ± SD：13.16 ± 6.49，共 24 个）。最终，一名患者死亡并休息出院。

结论

中风可能与年龄和肺部受累程度无关。然而，不同的因素可能在中风和 COVID-19 的同时发生及其结果中发挥作用。未来需要长期随访和更多病例的研究来评估预后因素。