[Clinical and pathophysiological features of stroke in patients with COVID-19]. / Klinicheskie i patofiziologicheskie osobennosti tserebral'nogo insul'ta u patsientov s COVID-19.

ABSTRACT

OBJECTIVE: To study of modern literature on the clinical and pathophysiological features of stroke in patients with a new coronavirus infection (COVID-19). MATERIAL AND METHODS: Published data were searched in the electronic databases Medline (PubMed) and eLIBRARY for the period 2019-2022. RESULTS: It has been shown that patients with COVID-19 have a large number of risk factors for stroke, which may indicate that COVID-19 is a trigger for the development of the disease. Stroke predominantly occurs in 10-14 days after the onset of COVID-19, i.e. there was a delayed manifestation. Patients with stroke due to a COVID-19 are characterized by occlusion of large vessels or vessels, in which occlusion occurs extremely rarely, as well as the presence of several lesions. Specific laboratory signs are coagulopathy, the presence of antiphospholipid antibodies, as well as impaired liver and kidney function. This cohort of patients is characterized by high mortality and poor functional outcome (in more than 70% of cases). The pathogenetic mechanism underlying stroke has not been established yet, however, in patients with COVID-19, the activation of a cascade of blood coagulation and thrombosis reactions is recorded. Suppression of ACE2 due to the affinity of its receptors for the COVID-19 virus probably also plays a role in the pathogenesis of stroke, since when the virus enters the body, an imbalance of the renin-angiotensin system develops. CONCLUSION: COVID-19 can lead to the development of various neurological diseases, including stroke. Further researches are needed to study neuropathogenesis of COVID-19 and the impact of virus SARS-CoV-2 on disease progression.