Neurological Complications of Covid-19: Focus on Acute Cerebrovascular Accidents

Аннотация

COVID-19, typically regarded as a respiratory illness, exhibits substantial neurological involvement, especially in severely affected patients. Acute cerebrovascular events, including ischemic and hemorrhagic strokes, are seen in relatively young, previously healthy individuals, linked to hypercoagulability and prothrombotic states. Neurological complications of COVID-19 may arise without direct central nervous system infection, stemming from a severe systemic reaction to the infection. Further research into the pathophysiology and clinical trials are needed to optimize strategies preventing long-term consequences and therapeutic choices. Keywords: COVID-19; SARS-CoV-2; neurological complications; acute cerebrovascular accident; ischemic stroke; cerebral haemorrhage; cerebral vein thrombosis; hypercoagulability; thrombosis. data from child and adult cohorts, as well as Introduction: Ischemic stroke remains one of the international clinical guidelines of AHA/ASA, ESO and leading causes of death and disability worldwide. NICE. Inclusion criteria: publications for 2000–2023, According to the Global Burden of Disease study, the English- and Russian-language articles, results of total number of disability-adjusted life years (DALYs) randomized controlled trials, cohort studies and due to stroke reached 143 million in 2019. Given the guidelines. The search was performed in the PubMed, aging population and the increasing number of risk Scopus and eLibrary databases. factors, the issue of long-term neurological and functional consequences of stroke is becoming RESULTS increasingly important. Despite advances in acute In 2019, the number of DALYs due to stroke was 143 therapy, such as extending the time frame for million. Stroke remains the second leading cause of endovascular thrombectomy to 24 hours in selected death and the third leading cause of disability cases, the need for a thorough understanding and worldwide. effective management of late consequences remains a Prospective study data showed that dementia affects key challenge in modern neurology and rehabilitation. up to 20% of patients in the acute phase and up to 39% METHODS of survivors one year after stroke. A study by A systematic review of the literature on the topics of Mehrabian et al. found that hippocampal atrophy is the remote neurological consequences of ischemic stroke strongest predictor of late post-stroke cognitive was conducted, including epidemiological studies, dysfunction. longitudinal cognitive and neuropsychological studies, Table 1 Prevalence of cognitive and neurological outcomes after ischemic stroke Outcome Group Frequency Dementia 1 year after stroke Adults 39% Moderate and severe neurological impairment 2 years later Children 9,4% American Journal Of Biomedical Science & Pharmaceutical Innovation 21 https://theusajournals.com/index.php/ajbspi American Journal of Applied Science and Technology (ISSN: 2771-2745) Incidence of recurrent MI/TIA in children Children 19% proportion of patients. In the United States, only 30.7% Movement disorders and post-stroke pain significantly of stroke survivors received outpatient rehabilitation. affect the quality of life and require a comprehensive In three Korean hospitals, 27.9% of patients received multidisciplinary approach to rehabilitation. rehabilitation counseling, 12.9% were transferred to Psychoemotional complications, such as depression rehabilitation departments. and anxiety disorders, are observed in a significant Table 2 Access to rehabilitation in patients after ischemic stroke Type of rehabilitation Population Percentage Outpatient rehabilitation Stroke Survivors 30,7% Rehabilitation consultation First Discharges from Three Korean 27,9% Hospitals Transfer to the rehabilitation First Discharges from Three Korean 12,9% department Hospitals rehabilitation services.