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Epidemiology, pathogenesis, and management of Coronavirus disease 2019-associated stroke

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Abstract

The Coronavirus disease 2019 (COVID-19) epidemic has triggered a huge impact on healthcare, socioeconomics, and other aspects of the world over the past three years. An increasing number of studies have identified a complex relationship between COVID-19 and stroke, although active measures are being implemented to prevent disease transmission. Severe COVID-19 may be associated with an increased risk of stroke and increase the rates of disability and mortality, posing a serious challenge to acute stroke diagnosis, treatment, and care. This review aims to provide an update on the influence of COVID-19 itself or vaccines on stroke, including arterial stroke (ischemic stroke and hemorrhagic stroke) and venous stroke (cerebral venous thrombosis). Additionally, the neurovascular mechanisms involved in SARS-CoV-2 infection and the clinical characteristics of stroke in the COVID-19 setting are presented. Evidence on vaccinations, potential therapeutic approaches, and effective strategies for stroke management has been highlighted.

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Acknowledgements

This study was supported by the National Natural Science Foundation of China (No. 82027802), Pharmaceutical Collaboration Project of the Beijing Science and Technology Commission (No. Z181100001918026), and Talents Gathering Project of Xuanwu Hospital, Capital Medical University.

Parts of the Figs. 1 and 2 were drawn by using pictures from Servier Medical Art, licensed under a Creative Commons Attribution 3.0 Unported License (https://creativecommons.org/licenses/by/3.0/).

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  1. Lu Liu and Chenxia Zhou share the first authorship.

Authors and Affiliations

  1. Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100032, China

    Lu Liu & Chenxia Zhou

  2. Neurology and Intracranial Hypertension and Cerebral Venous Disease Center, National Health Commission of China, Xuanwu Hospital, Capital Medical University, Beijing, 100032, China

    Lu Liu, Chenxia Zhou & Xunming Ji

  3. Beijing Institute of Brain Disorders, Capital Medical University, Beijing, 100069, China

    Huimin Jiang, Yifan Zhou, Chen Zhou & Xunming Ji

  4. Beijing Advanced Innovation Center for Big Data-Based Precision Medicine, School of Biological Science and Medical Engineering, Beihang University, Beijing, 100191, China

    Huimin Wei

  5. Department of Neurology, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China

    Chen Zhou

  6. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100032, China

    Xunming Ji

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Conflicts of Interest Lu Liu, Chenxia Zhou, Huimin Jiang, Huimin Wei, Yifan Zhou, Chen Zhou, and Xunming Ji declare that they have no conflict of interest.

This manuscript is a review article and does not involve a research protocol requiring approval by the relevant institutional review board or ethics committee.

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Supplemental Table 1

. Summary of cohort studies in the review.

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Liu, L., Zhou, C., Jiang, H. et al. Epidemiology, pathogenesis, and management of Coronavirus disease 2019-associated stroke. Front. Med. 17, 1047–1067 (2023). https://doi.org/10.1007/s11684-023-1041-7

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