ABSTRACT
Objective: To describe the difference in clinical presentation, including race, of ischemic stroke between patients with and without novel coronavirus disease 2019 (COVID-19), and the association of inflammatory response with stroke severity. Background: An inflammatory response to the virus has been a suggested mechanism of etiology for ischemic stroke in COVID-19 patients with limited evidence from prior studies. Neutrophilto-lymphocyte ratio (NLR) is an easily calculated lab measure indicating an underlying inflammatory process. Design/Methods: This is a retrospective, observational, cross-sectional study of patients (n=60) admitted with ischemic stroke between late March and early May 2020. All patients were tested for COVID-19 during admission. Demographic, clinical, and laboratory data was collected through electronic medical record review. Results: Nine out of the 60 stroke patients were positive for COVID-19. African-Americans comprised of 55.6% of those that had COVID-19 and stroke and 37.7% of those with only stroke. Stroke patients with COVID-19 had a significantly higher NIHSS [18.4 (8.8)] and NLR [7.3 (4.2) vs 3.8 (2.8);P=0.0137] than those without. Those with COVID-19 also had a significantly higher mortality rate (44.4% vs. 7.6%;p<0.001). Conclusions: We observed a cohort of patients, including a large proportion of AfricanAmericans, who developed ischemic stroke with or without COVID-19. An exaggerated inflammatory response, as indicated by NLR, likely plays a role in stroke severity among COVID-19 patients that concurrently develop ischemic stroke.