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  • Brinjikji, Waleed (author)

Endotheliitis and cytokine storm as a mechanism of clot formation in COVID-19 ischemic stroke patients: A histopathologic study of retrieved clots.

  • Article/chapterEnglish2023

Publisher, publication year, extent ...

  • 2023

Numbers

  • LIBRIS-ID:oai:gup.ub.gu.se/331650
  • https://gup.ub.gu.se/publication/331650URI
  • https://doi.org/10.1177/15910199231185804DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:153873184URI

Supplementary language notes

  • Language:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Studies during the COVID-19 pandemic have demonstrated an association between COVID-19 virus infection and the development of acute ischemic stroke, particularly large vessel occlusion (LVO). Studying the characteristics and immunohistochemistry of retrieved stroke emboli during mechanical thrombectomy for LVO may offer insights into the pathogenesis of LVO in COVID-19 patients. We examined retrieved COVID-19 emboli from the STRIP, EXCELLENT, and RESTORE registries and compared their characteristics to a control group.We identified COVID-positive LVO patients from the STRIP, RESTORE, and EXCELLENT studies who underwent mechanical thrombectomy. These patients were matched to a control group controlling for stroke etiology based on Trial of Org 10172 in Acute Stroke Treatment criteria. All clots were stained with Martius Scarlet Blue (MSB) along with immunohistochemistry for interleukin-6 (IL-6), C-reactive protein (CRP), von Willebrand factor (vWF), CD66b, fibrinogen, and citrullinated Histone H3. Clot composition was compared between groups.Nineteen COVID-19-positive patients and 38 controls were included. COVID-19-positive patients had a significantly higher percentage of CRP and vWF. There was no difference in IL-6, fibrin, CD66b, or citrullinated Histone H3 between groups. Based on MSB staining, there was no statistically significant difference regarding the percentage of red blood cells, white blood cells, fibrin, and platelets.Our study found higher concentrations of CRP and vWF in retrieved clots of COVID-19-positive stroke patients compared to COVID-19-negative controls. These findings support the potential role of systemic inflammation as indicated by elevated CRP and endothelial injury as indicated by elevated vWF as precipitating factors in thrombus development in these patients.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Kallmes, David F (author)
  • Virmani, Renu (author)
  • de Meyer, Simon F (author)
  • Yoo, Albert J (author)
  • Humphries, William (author)
  • Zaidat, Osama O (author)
  • Teleb, Mohamed S (author)
  • Jones, Jesse G (author)
  • Siddiqui, Adnan H (author)
  • Andersson, Tommy (author)
  • Nogueira, Raul G (author)
  • Gil, Sara Molina (author)
  • Douglas, Andrew (author)
  • Rossi, Rosanna (author)
  • Rentzos, Alexandros,1979Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology(Swepub:gu)xrenta (author)
  • Ceder, Erik (author)
  • Carlqvist, JeanetteGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology(Swepub:gu)xcajea (author)
  • Dunker, Dennis (author)
  • Jood, Katarina,1966Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xjooka (author)
  • Tatlisumak, TurgutGothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience(Swepub:gu)xtatlt (author)
  • Doyle, Karen M (author)
  • Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för radiologi (creator_code:org_t)

Related titles

  • In:Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences2385-2011

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