Stroke Revealing the Presence of SARS-CoV-2: Three Case Reports and a Review of the Literature

Introduction: The 2019 Corona (Covid-19) disease is considered a potential extrinsic factor in the genesis or aggravation of a stroke. Patients with severe Covid-19 are more likely to develop stroke. Comment: We report three cases of stroke including one intracerebral haematoma and two cases of cerebral ischaemia revealing Covid-19. A history of hypertension was found in two of our patients, no notion of contagion was reported. Neurological signs were preceded by at least three days of infectious syndrome and respiratory distress syndrome. These were consistent and associated. Our patients all tested positive for Covid-19. They all had a positive CRP. Lung lesions of the alveolar, interstitial and alveolo-interstitial type were found on lung imaging. All our patients were treated with oxygen therapy, paracetamol, chloroquine and azythromicyne. In addition, acetylsalicylic acid for ischaemic strokes and nicardipine for haemorrhagic stroke. We have recorded two death and one recovery, the youngest (52 years old) with no cardiovascular risk factors. Neurological signs and symptoms can be attributed to neuroinvasion of the virus, and cerebral hypoxia. The diagnosis of Covid-19 is not a contraindication to endovascular treatment for a stroke. Stroke increase the death rate during Covid-19. Conclusion: Stroke is less frequent during Covid-19. Neurological signs are non-specific and combine respiratory and infectious signs. The treatment is multidisciplinary and has a variable prognosis.