Stefania Nannoni (United Kingdom)
University of Cambridge
Stroke Research Group, Department of Clinical Neurosciences
I am a Clinical Research Fellow in the Stroke Research Group of the University of Cambridge (UK). Previously, I completed my medical degree and my neurology training at the University of Florence (Italy). Then, I spent two years in the Stroke Centre of Lausanne University Hospital (Switzerland) working as a cerebrovascular fellow. Recently, I have completed a PhD in Clinical Neurosciences with a research project focused on the neuroimaging selection of acute ischemic stroke patients for late endovascular treatment. Cerebrovascular diseases are my main clinical and research field of interest. My research projects within the Stroke Research Group include lacunar strokes, brain imaging and genetics of small vessel disease. More recently, I became interested in studying the relationship between stroke and Covid-19, and I published a meta-analysis on this topic (doi: 10.1177/1747493020972922.)

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 Conference Calendar

Does COVID-19 Really Cause Stroke: What Types and Why?

Session Name
0460 - COVID Thrombosis and Stroke (ID 2)
Session Type
Main Theme Symposium
Date
28.10.2021, Thursday
Session Time
17:45 - 19:15
Room
MAIN THEME A
Presenter
Lecture Time
18:08 - 18:31

Abstract

Abstract Body

Despite the reduced number of stroke patient admissions during the first wave of the COVID-19 pandemic, which has been recorded worldwide, COVID-19 patients seem to be at a higher risk of stroke. SARS-CoV-2 infection may act as a trigger or risk factor for stroke, and it is more likely to cause thrombotic vascular events compared to other coronavirus and seasonal infectious diseases. A pooled analysis of the literature suggested that acute cerebrovascular events occurred in about 1.4% of patients hospitalized for COVID-19. Individuals with COVID-19 who experience a concomitant stroke are more likely to be older, have pre-existing cardiovascular comorbidities and severe infection from SARS-CoV-2.

Ischemic stroke is the commonest stroke subtype in COVID-19 patients, even if hemorrhagic stroke and cerebral venous thrombosis have also been described. COVID-19-associated stroke is characterized clinically by severe NIHSS and poor outcome, and radiologically by large artery occlusion and multiple arterial territory involvement.

The mechanisms of cerebrovascular manifestations in people with COVID-19 are likely multifactorial. They could be related to conventional stroke mechanisms or be directly caused by SARS-CoV-2 infection through specific pathophysiological mechanisms, leading to both ischemic and hemorrhagic stroke. The SARS-CoV-2 can affect the endothelium, cause downregulation of the renin-angiotensin system and promote a procoagulant state; also, it may involve the heart, leading to an increased risk of cardioembolism. Further studies are required to estimate the increased stroke risk in COVID-19 and to elucidate the pathophysiology linking COVID-19 to stroke.

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