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Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza
Alexander E Merkler1, Neal S Parikh1, Saad Mir1
1Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, New York, New York.
JAMA Neurology
|July 3, 2020
Summary
Patients with coronavirus disease 2019 (COVID-19) had a significantly higher risk of ischemic stroke compared to those with influenza. This study highlights a potential thrombotic complication of COVID-19 requiring further investigation.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- The association between coronavirus disease 2019 (COVID-19) and ischemic stroke risk compared to other respiratory viral infections remains unclear.
- Influenza has been previously linked to an increased risk of stroke.
Purpose of the Study:
- To compare the incidence of ischemic stroke in patients diagnosed with COVID-19 versus those with influenza.
- To evaluate the potential increased risk of stroke associated with COVID-19.
Main Methods:
- Retrospective cohort study including adult patients from two New York City academic hospitals.
- COVID-19 cohort (March-May 2020) compared with influenza A/B cohort (January 2016-May 2018).
- Ischemic stroke adjudicated by neurologists; logistic regression used for comparison.
Main Results:
- 1.6% of COVID-19 patients experienced ischemic stroke versus 0.2% of influenza patients.
- Adjusted odds ratio for stroke in COVID-19 vs. influenza was 7.6 (95% CI, 2.3-25.2).
- This association remained significant after adjusting for various risk factors and clinical variables.
Conclusions:
- Adults with COVID-19 exhibited a higher rate of ischemic stroke than those with influenza.
- Further research is necessary to validate these findings and explore the underlying thrombotic mechanisms of COVID-19.
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