BackgroundsSeveral neurological manifestations, including stroke, have been reported in COVID-19 patients. The putative role of the COVID-19-related hyperinflammatory state in cerebrovascular disorders remains unclear.MethodsFrom March 2020 to September 2021, we searched for patients who exhibited an ischemic stroke related to carotid free-floating thrombus (CFFT) to investigate its incidence and relationship with COVID-19.ResultsOf 853 ischemic strokes referred to our Stroke Centre during the study period, 5.7% (n = 49) were positive for SARS-CoV-2. Six had CFFT, of which two tested positive for SARS-CoV-2 (2/49 = 4.1%), and four did not (4/802 = 0.5%). The former were two middle-aged men suffering from COVID-19 pneumonia. Floating thrombi were promptly extracted by endarterectomy and endovascular thrombectomy, respectively, with no early and long-term complications. Notably, our COVID-19 patients exhibited little or no atherosclerosis burden on CT angiography, markedly elevated D-dimer levels, and extensive thrombus length.ConclusionsCOVID-19-induced immunothrombosis possibly played a significant pathogenic role in CFFT.
Carotid free-floating thrombus in COVID-19: a cerebrovascular disorder of cytokine storm-related immunothrombosis / Pensato, Umberto; Forlivesi, Stefano; Gentile, Mauro; Romoli, Michele; Muccioli, Lorenzo; Ambrosi, Francesca; Foschini, Maria Pia; Gallo, Carmine; Ballestrazzi, Maria Sandra; Teutonico, Paolo; Faggioli, Gianluca; Gargiulo, Mauro; Galluzzo, Simone; Taglialatela, Francesco; Simonetti, Luigi; Zini, Andrea. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - ELETTRONICO. - 44:6(2023), pp. 1855-1860. [10.1007/s10072-023-06682-3]
Carotid free-floating thrombus in COVID-19: a cerebrovascular disorder of cytokine storm-related immunothrombosis
Pensato, Umberto
;Muccioli, Lorenzo
;Ambrosi, Francesca
;Foschini, Maria Pia
;Ballestrazzi, Maria Sandra
;Faggioli, Gianluca;Gargiulo, Mauro;
2023
Abstract
BackgroundsSeveral neurological manifestations, including stroke, have been reported in COVID-19 patients. The putative role of the COVID-19-related hyperinflammatory state in cerebrovascular disorders remains unclear.MethodsFrom March 2020 to September 2021, we searched for patients who exhibited an ischemic stroke related to carotid free-floating thrombus (CFFT) to investigate its incidence and relationship with COVID-19.ResultsOf 853 ischemic strokes referred to our Stroke Centre during the study period, 5.7% (n = 49) were positive for SARS-CoV-2. Six had CFFT, of which two tested positive for SARS-CoV-2 (2/49 = 4.1%), and four did not (4/802 = 0.5%). The former were two middle-aged men suffering from COVID-19 pneumonia. Floating thrombi were promptly extracted by endarterectomy and endovascular thrombectomy, respectively, with no early and long-term complications. Notably, our COVID-19 patients exhibited little or no atherosclerosis burden on CT angiography, markedly elevated D-dimer levels, and extensive thrombus length.ConclusionsCOVID-19-induced immunothrombosis possibly played a significant pathogenic role in CFFT.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
