key: cord-0688822-lrzw3imn
authors: Alay, Handan; Can, Fatma Kesmez; Gözgeç, Elif
title: Cerebral Infarction in an Elderly Patient with Coronavirus Disease
date: 2020-06-03
journal: Revista da Sociedade Brasileira de Medicina Tropical
DOI: 10.1590/0037-8682-0307-2020
sha: b0e6fc58feb5fd997fd6603d2fd520c731ff2f2e
doc_id: 688822
cord_uid: lrzw3imn

nan

An 82-year-old man presented with cough and weakness and admitted to our clinic. His body temperature was 38 0 C, heart rate 93 beats/min, respiratory rate 22 breaths/min, blood pressure 100/60 mmHg, and oxygen saturation 86% (oxygen mask 5 L/min). His blood leukocyte, neutrophil, lymphocyte, D-dimer, fibrinogen, c-reactive protein, ferritin, and procalcitonin levels were 8.56 x 10 3 /µL, 7.4x10 3 /µL, 0.62x 10 3 /µL, 2304 ng/mL, 638 mg/dL, 183 mg/L, 720 ng/mL, and 0.2 ng/mL, respectively. Computed tomography of the thorax revealed a suspected diagnosis of coronavirus disease (COVID-19) (Figure 1) . Antiviral (Favipavir 2 x 1600 mg loading, 2 x 600 mg maintenance) and antibacterial (levofloxacin 500 mg/day) therapies were initiated. The patient's oronasopharyngal swab specimen was positive for severe acute respiratory syndrome coronavirus 2 nucleic acid. Weakness and loss of muscle tone developed in the left arm on day 3 of treatment.

Brain diffusion magnetic resonance imaging showed multiple advanced stage infarctions (Figure 2) . Enoxaparin 0.5 mg/kg once every 12 hours and acetylsalicylic acid 100 mg 1x1 were added to treatment. The laboratory parameters improved. The patient was discharged on day 20. COVID-19 can result in cerebral infarction and death in the elderly 1, 2 . Anticoagulants are useful in elderly patients with high D-dimer due to the risk of coagulation dysfunction and cerebral infarction 3 . Thromboembolic complications must be considered in COVID-19 patients with known risk factors and abnormal laboratory findings.

HA: Conception and design of the study, analysis and interpretation of data, acquisition of data, writing, supervision, and final approval of the version to be submitted. FKC: Conception and design of the study, analysis, and interpretation of data, and supervision. EG: Conception and design of the study, analysis, and interpretation of data, and supervision.

Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study

Diagnosis and treatment of an elderly patient with secondary cerebral infarction caused by COVID-19

Nan Fang Yi Ke Da Xue Xue Bao

Thromboembolic risk and anticoagulant therapy in COVID-19 patients: emerging evidence and call for action

The authors declare that there are no conflicts of interest.