Establishing causality between SARS-CoV-2 and stroke/bleeding requires a temporal relationship and plausible pathophysiology

Abstract

Cerebrovascular events are increasingly recognized as a complication of SARS-CoV-2 infections. They can be due to hypercoagulability, vasculopathy, cardiac involvement in the infection, or autonomic dysfunction. However, establishing a causal relationship between cerebrovascular events and viral infection is not always easy and requires thorough investigation and documentation of a close temporal relationship between SARS-CoV-2 infection and the onset of cerebral impairment. Establishing a causal relationship between SARS-CoV-2 infection and cerebrovascular events is desirable as it can guide therapeutic management and determine the outcome.