PT  - JOURNAL ARTICLE
AU  - Mohamud, A.Y.
AU  - Griffith, B.
AU  - Rehman, M.
AU  - Miller, D.
AU  - Chebl, A.
AU  - Patel, S.C.
AU  - Howell, B.
AU  - Kole, M.
AU  - Marin, H.
TI  - Intraluminal Carotid Artery Thrombus in COVID-19: Another Danger of Cytokine Storm?
AID  - 10.3174/ajnr.A6674
DP  - 2020 Jul 02
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2020/07/02/ajnr.A6674.short
4100  - http://www.ajnr.org/content/early/2020/07/02/ajnr.A6674.full
AB  - SUMMARY: Coronavirus disease 2019 (COVID-19) is associated with a severe inflammatory response. Inflammation affects atherosclerotic plaque vulnerability and promotes a thrombogenic environment. We report a series of 6 patients with COVID-19 with acute ischemic stroke due to intraluminal carotid artery thrombus presenting during an 8-day period. Six patients were included (5 men) with a mean age of 65.8 years (range, 55–78 years). COVID-19 was diagnosed by detection of Severe Acute Respiratory Syndrome coronavirus 2 in 5 patients and was presumed due to typical clinical and imaging findings in 1 patient. All patients had vascular risk factors including diabetes (83%), hyperlipidemia (100%), and smoking (17%). Four patients presented with large infarcts with initial NIHSS scores of 24–30. During their hospitalization, all patients had elevated D-dimer and C-reactive protein levels, 5 patients had elevated lactate dehydrogenase and ferritin levels, 3 had elevated interleukin-6 levels, and 2 had elevated troponin levels. Inflammation related to COVID-19 may result in rupture of vulnerable atherosclerotic plaques, resulting in thrombosis and acute ischemic stroke.COVID-19coronavirus disease 2019ICTintraluminal carotid artery thrombusIL-6interleukin-6LVOlarge-vessel occlusionSARS-CoV-2Severe Acute Respiratory Syndrome coronavirus 2