LARGE VESSEL STROKE ISKEMIK PADA PASIEN COVID-19 : SEBUAH TINJAUAN SISTEMATIS
Abstract
Pendahuluan. Coronavirus 2019 (COVID-19) merupakan penyakit menular yang disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Komplikasi neurologis, khususnya stroke iskemik terkait dengan COVID-19, semakin banyak dilaporkan. Patofisiolognya masih belum jelas, tetapi penyakit COVID-19 yang berat dapat meningkatkan risiko Large vessel stroke, sehingga penting untuk memiliki pemahaman yang lebih mendalam tentang hubungan tersebut. Metode. Menggunakan dua alat pencarian yaitu Pubmed dan Google Scholar. Penelitian-penelitian yang dikumpulkan adalah yang diterbitkan pada periode Januari - Agustus 2020. Kata kunci yang digunakan adalah COVID-19 atau Coronavirus atau Severe acute respiratory syndrome coronavirus 2 atau SARS-CoV-2 dan ischemik stroke atau cerebral ischemia atau cerebral infarction atau ischaemic stroke dan vessel occlusion yang melaporkan kejadian large vessel stroke iskemik yang ditinjau secara sistematis menggunakan PRISMA. Hasil. Tinjauan sistematis kami mencakup data 16 artikel:, delapan laporan kasus, lima seri kasus dan tiga studi retrospektif. Umumnya pasien stroke iskemik dengan COVID-19 menunjukkan gambaran neuroimaging suatu large vessel occlusion pada pembuluh darah arteri serebri media dan arteri karotis interna, selain itu juga pada arteri serebri anterior, arteri serebri posterior, arteri serebelaris posterior inferior dan arteri basilaris. Umumnya juga terjadi pada usia dibawah 50 tahun. Faktor komorbid dilaporkan berupa hipertensi, diabetes melitus, hiperlipidemia, atrial fibrilasi, infark miokard, derajat severitas COVID-19 sedang-berat, faktor koagulasi (D-dimer) dan C-Reaktive protein (CRP) meningkat dan mempengaruhi outcome. Kesimpulan. Pengamatan kami menunjukkan bahwa large vessel occlusion dengan infeksi Covid-19 memiliki karakteristik yang berbeda sehingga berimplikasi terhadap diagnosis dan terapi.
Kata kunci : Covid-19, Large vessel occlusion, SARS-Co-2, Severity COVID-19, stroke iskemik.
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