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Racial differences and an increased systemic inflammatory response are seen in patients with COVID-19 and ischemic

Chen Lin1, Yurany A Arevalo1, Hely D Nanavati2

  • 1Department of Neurology, The University of Alabama at Birmingham, Birmingham, AL, 35294, USA.

Brain, Behavior, & Immunity - Health
|September 9, 2020
PubMed

Insights

COVID-19 significantly increases ischemic stroke severity and mortality, particularly in African Americans. An elevated neutrophil-to-lymphocyte ratio (NLR) indicates a heightened inflammatory response associated with worse outcomes in stroke patients with COVID-19.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Immunology

Background:

  • Novel coronavirus disease 2019 (COVID-19) has been associated with various neurological complications.
  • Ischemic stroke is a serious potential complication, and its clinical presentation in the context of COVID-19 requires further elucidation, particularly regarding racial disparities and inflammatory markers.

Purpose of the Study:

  • To compare the clinical presentation of ischemic stroke in patients with and without COVID-19, focusing on racial differences.
  • To investigate the association between the inflammatory response, specifically the neutrophil-to-lymphocyte ratio (NLR), and stroke severity in patients with COVID-19.

Main Methods:

  • A retrospective, observational, cross-sectional study was conducted on 60 patients admitted with ischemic stroke.
  • Patients were tested for COVID-19 upon admission, and demographic, clinical, and laboratory data were collected.
  • Descriptive statistics were used to compare stroke patients with and without COVID-19.

Main Results:

  • Nine out of 60 patients tested positive for COVID-19.
  • African Americans represented a higher proportion of stroke patients with COVID-19 (55.6%) compared to those without (37.7%).
  • COVID-19 positive stroke patients exhibited significantly higher NIH Stroke Scale (NIHSS) scores and NLR compared to COVID-19 negative patients. Mortality rates were substantially higher in the COVID-19 positive group (44.4% vs. 7.6%).

Conclusions:

  • Ischemic stroke patients with COVID-19, including a notable proportion of African Americans, presented with increased severity.
  • An exaggerated inflammatory response, indicated by elevated NLR, is likely linked to greater stroke severity in patients with concurrent COVID-19 and ischemic stroke.
Abstract

Keywords:
COVID-19Coronavirus immune responseNeutrophil-to-lymphocyte ratioRacial disparitiesStroke

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