{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:35:14Z","timestamp":1784115314620,"version":"3.55.0"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose:<\/jats:title>\n                    <jats:p>Stroke may complicate coronavirus disease 2019 (COVID-19) infection based on clinical hypercoagulability. We investigated whether transcranial Doppler ultrasound has utility for identifying microemboli and clinically relevant cerebral blood flow velocities (CBFVs) in COVID-19.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed transcranial Doppler for a consecutive series of patients with confirmed or suspected COVID-19 infection admitted to 2 intensive care units at a large academic center including evaluation for microembolic signals. Variables specific to hypercoagulability and blood flow including transthoracic echocardiography were analyzed as a part of routine care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Twenty-six patients were included in this analysis, 16 with confirmed COVID-19 infection. Of those, 2 had acute ischemic stroke secondary to large vessel occlusion. Ten non-COVID stroke patients were included for comparison. Two COVID-negative patients had severe acute respiratory distress syndrome and stroke due to large vessel occlusion. In patients with COVID-19, relatively low CBFVs were observed diffusely at median hospital day 4 (interquartile range, 3\u20139) despite low hematocrit (29.5% [25.7%\u201331.6%]); CBFVs in comparable COVID-negative stroke patients were significantly higher compared with COVID-positive stroke patients. Microembolic signals were not detected in any patient. Median left ventricular ejection fraction was 60% (interquartile range, 60%\u201365%). CBFVs were correlated with arterial oxygen content, and C-reactive protein (Spearman \u03c1=0.28 [\n                      <jats:italic>P<\/jats:italic>\n                      =0.04]; 0.58 [\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001], respectively) but not with left ventricular ejection fraction (\u03c1=\u22120.18;\n                      <jats:italic>P<\/jats:italic>\n                      =0.42).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this cohort of critically ill patients with COVID-19 infection, we observed lower than expected CBFVs in setting of low arterial oxygen content and low hematocrit but not associated with suppression of cardiac output.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.120.032150","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T05:19:09Z","timestamp":1618982349000},"page":"2422-2426","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Transcranial Doppler in Acute COVID-19 Infection"],"prefix":"10.1161","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4548-7353","authenticated-orcid":true,"given":"Wendy C.","family":"Ziai","sequence":"first","affiliation":[{"name":"Division of Neurosciences Critical Care (W.C.Z., S.-M.C., B.E.), Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Min","family":"Cho","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care (W.C.Z., S.-M.C., B.E.), Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle C.","family":"Johansen","sequence":"additional","affiliation":[{"name":"Division of Stroke (M.C.J., M.N.B.), Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahattin","family":"Ergin","sequence":"additional","affiliation":[{"name":"Division of Neurosciences Critical Care (W.C.Z., S.-M.C., B.E.), Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona N.","family":"Bahouth","sequence":"additional","affiliation":[{"name":"Division of Stroke (M.C.J., M.N.B.), Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.1127"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2008597"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1712155"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552-6569.2010.00523.x"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.29.3.725"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.14768"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2019373"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202006-2219LE"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.1987.61"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.21.11.1579"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1996.81.3.1084"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.51.8.1051"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0301-5629(98)00135-5"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.23.10.1487"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.047349"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.120.032150","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:18:36Z","timestamp":1715599116000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.120.032150"}},"subtitle":["Unexpected Associations"],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1161\/STROKEAHA.120.032150"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.120.032150","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.739980879.793593163","asserted-by":"object"}]},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]},"assertion":[{"value":"2020-08-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-24","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}