Analysis of the impact factors on early neurological deterioration in patients with cerebral infarction combined with coronavirus disease 2019 / 临床神经病学杂志

ABSTRACT

Objective To explore the impact factors on early neurological deterioration(END)in patients with cerebral infarction combined with coronavirus disease 2019(COVID-19).Methods The clinical characteristics and laboratory of patients with acute ischemic stroke and COVID-19 in Brain Hospital Affiliated to Nanjing Medical University were retrospectively analyzed from December 15,2022 to January 15,2023.According to whether or not END occurred,all patients were divided into END group and non-END group.The clinical data of two groups were analyzed.Results A total of eligible 56 patients were included in this study,with 16 cases in END group and 40 cases in non-END group.The average age of END group(74.31±12.04)was older than non-END group(67.18±8.15)(P＜0.05).The proportion of previous history of coronary heart disease and diabetes were higher than non-END group(all P＜0.05).In terms of laboratory examination,the number of monocytes,C-reactive protein,glycated hemoglobin,lactate dehydrogenase,myoglobin,albumin,D-dimer,and fibrin degradation products in END group were significantly higher than that in non-END group(all P＜0.05).Logistic analysis showed that C-reactive protein is an independent risk factor for cerebral infarction combined with COVID-19(OR =1.084,95%CI:1.002-1.173,P＜0.05).Area under the ROC curve was0.825(95%CI:0.709-0.941,P＜0.001).Conclusions For patients with cerebral infarction combined with COVID-19,early neurological deterioration is more likely to occur in elderly patients with multiple underlying diseases,abnormal coagulation and inflammation indicators.Increased C-reactive protein has good predictive ability.