The sudden worldwide outbreak of Coronavirus Disease 2019 (COVID-19) has certainly provided new challenges in the management of acute ischaemic stroke, and the risk-benefit ratio of intravenous thrombolysis in COVID-19 positive patients is not well known. We describe four COVID-19 patients treated with intravenous thrombolysis for acute ischaemic stroke. Although rt-PA administration is the main therapeutic strategy, our patients experienced unpredictable complications and showed atypical features: the overall mortality was very high. In conclusion, in this article, we provide information about these cases and discuss the possible explanation behind this trend.

2019 年冠状病毒病 (COVID-19) 在全球范围内的突然爆发无疑给急性缺血性卒中的管理带来了新的挑战，而 COVID-19 阳性患者静脉溶栓的风险效益比尚不清楚。我们描述了四名接受静脉溶栓治疗急性缺血性卒中的 COVID-19 患者。虽然 rt-PA 给药是主要的治疗策略，但我们的患者经历了不可预测的并发症并表现出非典型特征：总体死亡率非常高。总之，在本文中，我们提供了有关这些案例的信息，并讨论了这一趋势背后的可能解释。