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SARS-CoV-2 and Stroke in a New York Healthcare System

Shadi Yaghi1, Koto Ishida1, Jose Torres1

  • 1Department of Neurology (S.Y., K.I., J.T., K.H., T.T., K.L., S.A., M.S., S.K., E.S., A.L., J.F.), NYU Langone Health, New York, NY.

Stroke
|May 21, 2020
PubMed

Insights

Patients with COVID-19 and ischemic stroke had more cryptogenic strokes and higher mortality. Further research is needed on anticoagulation for stroke prevention in coronavirus disease 2019 patients.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Cardiology

Background:

  • Coronavirus disease 2019 (COVID-19) is associated with coagulopathy and thromboembolic events.
  • Ischemic stroke is a potential complication, but data on its characteristics and outcomes in COVID-19 patients are limited.

Purpose of the Study:

  • To investigate the clinical characteristics, stroke mechanisms, and outcomes of ischemic stroke in patients with COVID-19.
  • To compare these patients with contemporary and historical stroke cohorts without COVID-19.

Main Methods:

  • Retrospective cohort study of ischemic stroke patients hospitalized between March and April 2020.
  • Comparison of COVID-19 positive stroke patients with contemporary (COVID-19 negative) and historical stroke controls.

Main Results:

  • 0.9% of hospitalized COVID-19 patients had ischemic stroke.
  • Cryptogenic stroke was more frequent in COVID-19 patients (65.6%).
  • COVID-19 stroke patients exhibited higher NIH Stroke Scale scores, elevated D-dimer levels, and increased mortality compared to controls.

Conclusions:

  • Ischemic stroke in COVID-19 patients is rare but associated with a higher proportion of cryptogenic strokes and increased mortality.
  • Acquired hypercoagulability may contribute to stroke in COVID-19.
  • Further studies are required to evaluate the role of therapeutic anticoagulation for stroke prevention in COVID-19.
Abstract

Keywords:
COVID-19coronavirusdiagnosispandemictroponin

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