COVID-19 is a viral pneumonia with symptoms like high fever and dry cough. The patients also complain about shortness of breath, loss of taste, and smell. It is due to the SARS-CoV-2 virus, which can also influence ischemic stroke. The evidence is unsubstantial as previous studies used mild strokes and poor controls. This study determines the COVID-19 association with stroke outcomes.
The case-control study got conducted in 13 England and Scotland hospitals. The data of 86 strokes in COVID-19 patients was collected at the stroke onset. It included 81 ischemic and 5 intra-cerebral hemorrhage cases. This data got compared with 1384 stroke patients who never had COVID-19. The control group had 1193 ischemic and 191 intra-cerebral hemorrhage cases. The study also had 37 patients who had COVID-19 after the stroke. Two logistical regression analyses helped to independently associate features with COVID-19 and mortality of inpatients.
Asians were more likely to get an ischemic stroke at 18.8% compared to 6.7% controls. About 17.9% of them were more vulnerable to multiple large vessel occlusions. While only 8.1% of control cases were susceptible. The stroke cases had a median National Institutes of Health Stroke Scale score of 8 (5 in controls). Their D-dimer levels were higher and severe disability after discharge score on median modified Rankin Scale score was 4 (3 in controls).
The in-patient death of strokes vs. controls was at 19.8% vs. 6.9%. Stroke recurrence in cases and controls was very low at 2.3% vs. 1.0%. COVID-19 is a significant modifier of acute ischemic stroke’s onset, characteristics, and outcome.
Ref: https://jnnp.bmj.com/content/early/2020/11/19/jnnp-2020-324927
