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. 2021 Sep 21;64(6):349–365. doi: 10.11622/smedj.2021100

Table 1.

Reports of strokes in patients with severe acute respiratory syndrome coronavirus-2.

Study n Type of event Presentation Radiological anatomy/vascular territory Time from disease onset (day) Anti-phospholipid antibody status Coagulation parameters
Mao et al.[37] 5 4 ischaemic strokes, 1 haemorrhagic stroke Not described Not described 1–18 (median 9) Not described Not described

Helms et al.[41] 3 All ischaemic strokes Incidental finding on MR imaging done for encephalopathy Small hyperintensity lesions on MR imaging Not described Not described Not described

Zhang et al.[24] 3 All ischaemic strokes Aged 65–70 yr, headache and digital ischaemia Multifocal infarcts including frontal, parietal, occipital lobes, basal ganglia, brainstem and cerebellum 10, 18, 33 Positive anticardiolipin IgA, anti-β2-glycoprotein-I IgA and IgG in all patients Elevated PT, aPTT, D-dimer and reduced platelets

Oxley et al.[38] 5 All ischaemic strokes Aged 33–49 yr, focal neurological deficits NIHSS score 13-23 1 internal carotid artery, 3 MCA, 1 posterior cerebral artery Not described Not described Prolonged PT or aPTT in 3 patients, elevated D-dimer and fibrinogen in 3 patients

Beyrouti et al.[25] 6 All ischaemic strokes Aged 53–85 yr, acute confusion with focal neurological deficits 5 multifocal infracts, 2 patients developed ischaemic stroke despite therapeutic anticoagulation −2 to 24 (median 12.5) 5 patients with lupus anticoagulant, 1 patient with medium-titre IgM anticardiolipin Prolonged PT or aPTT in 2 patients, elevated fibrinogen in 4 patients, elevated D-dimer in all patients

Avula et al.[39] 4 All ischaemic strokes Aged 73–88 yr, focal neurological deficits, NIHSS score 2-36 2 MCA, 1 frontal lobe, 1 medial temporal lobe 1–3 (median 2) Not described Prolonged PT or aPTT in 2 patients, elevated D-dimer in 2 patients

Gu et al.[74] 1 Ischaemic stroke Aged 78 yr with right-sided weakness, NIHSS score 2. A physician involved in treatment contracted COVID-19 3 days later CT brain unremarkable −2 Not described Normal PT and aPTT

He et al.[40] 1 Ischaemic stroke with concurrent subarachnoid hemorrhage Aged 70 yr with anisocoria Not described 28 Not described Severe thrombocytopenia and elevated D-dimer

Zhou et al.[42] 1 Ischaemic stroke Aged 75 yr with bilateral deep vein thrombosis Bilateral cerebral infarcts involving the middle and anterior cerebral artery on the right and anterior cerebral artery on the left 15 Not described Normal coagulation profile, elevated D-dimer

Sharifi- Razavi et al.[73] 1 Haemorrhagic stroke Aged 75 yr, drowsiness and extensor plantars Massive intracerebral haemorrhage in the right hemisphere, accompanied by intraventricular and subarachnoid haemorrhage 3 Not described Prolonged aPTT, normal platelet count

Hughes et al.[44] 1 Cerebral venous sinus thrombosis Aged 59 yr with headache and weakness Cerebral venous sinus thrombosis Not described Not described Not described

Garaci et al.[43] 1 Cerebral venous sinus thrombosis Aged 44 yr with drowsiness, aphasia and hemiparesis with concurrent pulmonary embolism Empty delta sign in the vein of Galen, straight sinus and in the torcular herophili due to dural sinus thrombosis with poor representation of left internal cerebral vein 14 Absence of anticardiolipin and anti-β2 glycoprotein IgM and IgG Severe thrombocytopenia and elevated D-dimer

aPTT: activated partial thromboplastin time, CT: computed tomography, IgA: immunoglobulin A, IgG: immunoglobulin G, IgM: immunoglobulin M, MCA: middle cerebral artery, MR: magnetic resonance, NIHSS: National Institutes of Health Stroke Scale, PT: prothrombin time