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Ischemic stroke in COVID-19: A need for early identification and management
Neurology ; 96(15 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1407859
ABSTRACT

Objective:

We aimed to describe the clinical and radiographic characteristics of patients who were admitted with COVID-19 and had an acute ischemic stroke.

Background:

In the setting of the Coronavirus Disease 2019 (COVID-19) global pandemic caused by SARS-CoV-2, a potential association of this disease with stroke has been suggested. Design/

Methods:

This is a case series of PCR-confirmed COVID-19 patients with ischemic stroke admitted to an academic health system in Atlanta, Georgia (USA) between March 24th, 2020 and July 17th, 2020. Demographic, clinical, and radiographic characteristics were described.

Results:

Of 396 ischemic stroke patients admitted during this study period, 13 (2.5%) were also diagnosed with COVID-19. The mean age of patients was 61.6 ± 10.8 years, 10 (76.9%) male, 8 (61.5%) were Black Americans, mean time from last normal was 4.97 ± 5.1 days, and only one received acute reperfusion therapy. All 13 patients had at least one stroke-associated comorbidity. The predominant pattern of ischemic stroke was embolic with 4 explained by atrial fibrillation. COVID-19 patients had a significantly higher rate of cryptogenic stroke than nonCOVID-19 patients during the study period (69% vs 17%, p=0.0001). 4 patients (30.7%) died by the end of the study period.

Conclusions:

In our case series, ischemic stroke affected COVID-19 patients with traditional stroke risk factors, but mainly affecting males and Black Americans. We observed a predominantly embolic pattern of stroke with a higher than expected rate of cryptogenic strokes, a prolonged median time to presentation and symptom recognition limiting the use of acute reperfusion treatments along with a high mortality. These results highlight the need for increased community awareness, early identification, and management of AIS in COVID-19 patients. Further studies to determine the effects of COVID-19 associated coagulopathy on ischemic stroke risk as well as the interactions between COVID-19 and other known stroke risk factors are warranted.
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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Neurology Year: 2021 Document Type: Article

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Collection: Databases of international organizations Database: EMBASE Language: English Journal: Neurology Year: 2021 Document Type: Article