ABSTRACT
Background and aims: Coronavirus disease (COVID-19) can predispose to vascular and neurological complications, through inflammatory and thrombogenic mechanisms. There is a high incidence of stroke and of COVID-19 in Brazil, making it important we better understand the association between stroke and SARS-CoV-2 infection. In view of this, we set up a NeuroCOVID study. Methods: This prospective case-control study is recruiting across 12 healthcare centres across all five Brazilian regions. We will enroll 1,000 stroke cases and 1,800 inpatients with other nonvascular acute diseases as controls with a 1:2 ratio. The main outcome is acute stroke (ischemic, haemorrhagic, venous thrombosis). The exposure is SARSCOV- 2 infection: previous (positive IgG), subacute (positive IgA) or acute (virus detected in nasopharynx). The Protect Code Stroke Protocol was translated into Portuguese to be validated in our population. All participants will respond to standardized questionnaires and have blood and nasopharyngeal swab samples collected at baseline, after signing the consent form (ethics approval no CAAE36538320.9.0000.5190). Results: Our pilot study ran at Hospital da Restauração (Northeast Brazil), from the 11th to 31st of December and included 20 cases (mean age 59 years;50% female) and 14 controls (mean age 52 years;36% female). Four patients had asymptomatic acute SARS-CoV-2 infection, all of them in the case group (20%). Conclusion: These preliminary results support our hypothesis of an association between SARS-CoV-2 and acute stroke in Brazil. The final report of the NeuroCOVID study will provide definitive evidence, along with similar studies worldwide.