Introduction

Coronavirus disease 2019 has been associated with stroke, particular characteristics of these patients are not fully understood. The adequate management of these patients depends on the comprehension of factors such as temporality, clinical presentation and etiology. We hypothesize there is an important temporal relationship between COVID-19 severity and stroke onset.

Methods

a systematic review of the available literature was conducted using Pubmed and Scopus, studies reporting patients with Coronavirus disease 19 and stroke were included. Clinical, sociodemographic and laboratory characteristics of patients were extracted and analyzed.

Results

Forty-seven studies and 176 patients were included, with a mean age of 63.1 years (SD= 16 n=122), most of them were males (63.2% n=171). The most frequent etiology was cryptogenic 40.9% n=66), and a mean National Institute of Health Stroke Scale of 14.4 points was found (SD= 8.6 n=73). Large vessel occlusion was reported in 65.9% patients (n=91) and these patients were younger with greater stroke severity. D-dimer, C-reactive protein, fibrinogen, ferritin and lactate dehydrogenase were elevated in most patients with reported findings. Most patients had severe Coronavirus disease 2019. The mean time from onset of respiratory symptoms to stroke was 9 days (SD=9.9), the shortest time was noted in those with mild and moderate disease.

Conclusions

There is a trend between the severity of Coronavirus disease 2019 and time to stroke onset. Also, age and stroke severity were found to be related to the development of large vessel occlusion. Inflammation and hypercoagulability markers are elevated in this disease, we propose to not discard hypercoagulability secondary to severe acute respiratory syndrome-coronavirus-2 as an underlying cause of stroke in these patients.

中文翻译：

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全球冠状病毒病2019年患者的中风发作时间：系统评价和分析

介绍

2019年冠状病毒病与中风有关，这些患者的特殊特征尚不完全清楚。对这些患者的适当管理取决于对诸如暂时性，临床表现和病因等因素的理解。我们假设COVID-19严重程度与中风发作之间存在重要的时间关系。

方法

使用Pubmed和Scopus对现有文献进行了系统的综述，包括报告有冠状病毒病19和中风的患者的研究。提取并分析患者的临床，社会人口学和实验室特征。

结果

包括47项研究和176例患者，平均年龄为63.1岁（SD = 16 n = 122），其中大多数为男性（63.2％n = 171）。最常见的病因是隐源性的40.9％n = 66），平均美国国立卫生研究院卒中量表的得分为14.4分（SD = 8.6 n = 73）。据报道有65.9％的患者发生大血管闭塞（n= 91），这些患者较年轻，卒中严重程度更高。在报告有发现的大多数患者中，D-二聚体，C反应蛋白，纤维蛋白原，铁蛋白和乳酸脱氢酶升高。大多数患者患有严重的冠状病毒病2019。从呼吸道症状发作到中风的平均时间为9天（SD = 9.9），在中度和中度疾病患者中发现的时间最短。

结论

在2019年冠状病毒疾病的严重程度和中风发作时间之间存在趋势。而且，发现年龄和中风的严重性与大血管闭塞的发展有关。在这种疾病中炎症和高凝标志物升高，我们建议不要丢弃继发于严重急性呼吸综合症冠状病毒2的高凝作为中风的潜在原因。