Assessment of mortality risk in Covid-19 patients with ischemic cerebrovascular disease

ABSTRACT

Background and aims: Covid-19 associated cerebrovascular complications have been frequently reported. There are many publications about the risk of developing cerebrovascular disease (CVD) during or after Covid-19. In this study, factors affecting mortality in patients with ischemic CVD during or after Covid-19 were investigated. Methods: For this purpose, data of 20 Covid-19 patients who were diagnosed with ischemic CVD during hospitalization were retrospectively analyzed and correlation analyzes were performed. Results: 70% of the patients had hypertension, 50% had diabetes, 45% had cardiac disease, 20% had a history of CVD. Hypercoagulability was detected in 85%. Ischemic involvement in multi-vessel areas was observed in 60%. Mortality rate after CVD was 55%. There was no significant correlation between mortality and gender, hypertension, diabetes, cardiac disease, or previous cerebrovascular disease. Prophylactic anticoagulant was started after Covid-19 was detected in all patients evaluated. No significant correlation was observed between antiaggregant or anticoagulant use and mortality. Mortality was found to be statistically significantly higher in patients with ischemia in the multivessel area (p=0.028). It was found that the NIH scores of those who had ischemic CVD between 12-25 days of Covid-19, were statistically significantly higher (p=0.031). Conclusion: In this report, factors affecting mortality in patients with coexistence of Covid-19 and ischemic CVD were investigated. Mortality is higher in ischemia affecting multi vessel areas. Clinical findings are more severe in people who had ischemic CVD after 12. day of Covid-19. It is possible to associate this finding with the emergence of cytokine storm at a later stage of the infection.