COVID-19 associated stroke - a single centre experience

Background and Purpose: Various neurological complications have been reported in association with COVID-19. We report our experience of COVID-19 with stroke at a single center over a period of eight months spanning 1 March to 31 October 2020.

COVID-19 associated stroke — A single centre experience

Background and Purpose: Various neurological complications have been reported in association with COVID-19. We report our experience of COVID-19 with stroke at a single center over a period of eight months spanning 1 March to 31 October 2020. Methods: We recruited all patients admitted to Internal Medicine with an acute stroke, who also tested positive for COVID-19 on RTPCR. We included all stroke cases in our analysis for prediction of in-hospital mortality, and separately analyzed arterial infarcts for vascular territory of ischemic strokes. Results: There were 62 stroke cases among 3923 COVID-19 admissions (incidence 1.6%). Data was available for 58 patients {mean age 52.6 years;age range 17–91;F/M=20/38;24% (14/58) aged ≤40;51% (30/58) hypertensive;36% (21/58) diabetic;41% (24/58) with O2 saturation <95% at admission;32/58 (55.17 %) in-hospital mortality}. Among 58 strokes, there were 44 arterial infarcts, seven bleeds, three arterial infarcts with associated cerebral venous sinus thrombosis, two combined infarct and bleed, and two of indeterminate type. Among the total 49 infarcts, Carotid territory was the commonest affected (36/49;73.5%), followed by vertebrobasilar (7/49;14.3%) and both (6/49;12.2%). Concordant arterial block was seen in 61% (19 of 31 infarcts with angiography done). ‘Early stroke’ (within 48 hours of respiratory symptoms) was seen in 82.7% (48/58) patients. Patients with poor saturation at admission were older (58 vs 49 years) and had more comorbidities and higher mortality (79% vs 38%). Mortality was similar in young strokes and older patients, although the latter required more intense respiratory support. Logistic regression analysis showed that low Glasgow coma score (GCS) and requirement for increasing intensity of respiratory support predicted in-hospital mortality. Conclusions: We had a 1.6% incidence of COVID-19 related stroke of which the majority were carotid territory infarcts. In-hospital mortality was 55.17%, predicted by low GCS at admission. © 2021 Journal of Association of Physicians of India. All rights reserved.

COVID-19 and kidney

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) causes a severe acute respiratory illness but also has a major crosstalk with other organs. Amongst these, the kidney is described as a major target for the infection related acute complications with even a pre-existing abnormal kidney function becoming a risk factor for severe infection and adverse outcomes.