Since the early days of the pandemic, there have been several reports of cerebrovascular complications during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Numerous studies proposed a role for SARS-CoV-2 in igniting stroke. In this review, we focused on the pathoetiology of stroke among the infected patients. We pictured the results of the SARS-CoV-2 invasion to the central nervous system (CNS) via neuronal and hematogenous routes, in addition to viral infection in peripheral tissues with extensive crosstalk with the CNS. SARS-CoV-2 infection results in pro-inflammatory cytokine and chemokine release and activation of the immune system, COVID-19-associated coagulopathy, endotheliitis and vasculitis, hypoxia, imbalance in the renin-angiotensin system, and cardiovascular complications that all may lead to the incidence of stroke. Critically ill patients, those with pre-existing comorbidities and patients taking certain medications, such as drugs with elevated risk for arrhythmia or thrombophilia, are more susceptible to a stroke after SARS-CoV-2 infection. By providing a pictorial narrative review, we illustrated these associations in detail to broaden the scope of our understanding of stroke in SARS-CoV-2-infected patients. We also discussed the role of antiplatelets and anticoagulants for stroke prevention and the need for a personalized approach among patients with SARS-CoV-2 infection.
【저자키워드】 COVID-19, SARS-CoV-2, stroke, Blood coagulation, Pharmacology, renin-angiotensin system, pathophysiology, neuroimmunomodulation, 【초록키워드】 viral infection, coronavirus, pandemic, hypoxia, SARS-COV-2 infection, Infection, Comorbidity, risk, drug, immune system, medications, chemokine, Endotheliitis, arrhythmia, Coagulopathy, Patient, Complication, Vasculitis, Central nervous system, incidence, CNS, association, Anticoagulant, antiplatelet, Invasion, cardiovascular complication, acute respiratory syndrome, Activation, infected patients, pro-inflammatory cytokine, SARS-CoV-2-infected patients, approach, susceptible, addition, elevated, Numerous, hematogenous, ill patients, neuronal, patients with SARS-CoV-2, peripheral tissue, the SARS-CoV-2,