ABSTRACT
Background: Acute ischemic stroke (AIS) is a frequent complication of coronavirus disease (COVID-19), but the prognosis of these patients is poorly understood. Aim: To explore the impact of COVID-19 on neurological outcome in AIS patients. Methods: A comparative retrospective cohort study was conducted in 32 consecutive AIS patients with and 51 without COVID-19 between the 1st of March 2020 and 1st of May 2021. The evaluation was based on a detailed chart review for demographic data, medical history, stroke severity, cranial and vessel imaging results, laboratory parameters, COVID-19 severity, hospitalization time, in-hospital mortality, and functional deficits at discharge (modified Rankin Scale, mRS). Results: COVID-19 AIS patients had worse initial neurological deficit (NIHSS 9 (3-13) vs. 4 (2-10);p=0.06), showed tendency to higher rate of large vessel occlusion (LVO;13/32 vs. 14/51;p=0.21), had prolonged hospitalization (19.4 ± 17.7 vs. 9.7 ± 7 days;p=0.003), had lower chance of functional independence (mRS≤2) (12/32 vs. 32/51;p=0.02) and showed higher in-hospital mortality (10/32 vs. 6/51;p=0.02). In COVID-19 AIS patients, LVO was more common with COVID-19 pneumonia than without (55.6% vs. 23.1%;p=0.139). Conclusion: COVID-19-related AIS carries a worse prognosis. COVID- 19 with pneumonia seems to be associated with a higher rate of LVO.