Evolution of the structure of cerebrovascular accidents with COVID-19
SARS-CoV-2 infection causes thrombotic vascular diseases including stroke more often than other infectious diseases. However, whether this changes the structure of acute cerebrovascular accident (ACV), whether it is affected by the dominant SARS-CoV-2 coronavirus strain, remains unclear. Objective: to determine the influence of COVID-19 on stroke depending on possible consequences of dominant SARS-CoV-2 strain. Material and methods. 6619 patient charts from statistical data of regional vascular centre in Botkin Hospital have been analysed, divided into periods depending on dominant SARS-CoV-2 strain. Results. As a result of the analysis it was determined that during COVID-19 pandemic the number of patients admitted with acute cerebrovascular accidents in 2nd period was higher. The number of subarachnoid hemorrhage cases in 2nd and 3rd periods is the same and is much higher than before COVID-19. During the pandemic lethality from cerebrovascular accidents with ischemic strokes was higher in 2nd and 3rd periods. Among elderly women as well as elderly men the number of lacunar strokes in 3rd period is 2.5 times lower in comparison with 2nd period. Lethality from hemorrhagic stroke stays the same. Ischemic strokes during the pandemic are worse and more often end with fatal outcome. Conclusion. This study shows that new coronavirus infection influences the structure of acute cerebrovascular accidents, and differences in structure depending on dominant strain are visible. It may be suggested that the number of cerebrovascular accidents with COVID-19 can be influenced by factors promoting clotting: damage of platelet hemostasis, coagulopathy, endothelial dysfunction, destabilization of atherosclerotic plaque causing cerebrovascular pathology.