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Increased risk of acute stroke among patients with severe COVID-19: a multicenter study and meta-analysis

T Siepmann1, A Sedghi1, E Simon1

  • 1Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden.

European Journal of Neurology
|September 13, 2020
PubMed

Insights

The risk of acute stroke is higher in patients with severe coronavirus disease 2019 (COVID-19). This study analyzed hospitalized COVID-19 patients, finding a significant association between disease severity and stroke risk.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19) has been linked to thromboembolic events.
  • Potential mechanisms include increased blood coagulability and endothelial inflammation.
  • The specific risk of acute stroke in COVID-19 patients requires further definition.

Purpose of the Study:

  • To determine the risk of acute stroke in patients with severe versus non-severe COVID-19.
  • To characterize acute stroke incidence in hospitalized COVID-19 patients.
  • To synthesize data from multicenter studies and systematic reviews.

Main Methods:

  • Observational, multicenter cohort study in four German hospitals.
  • Systematic review of PubMed/MEDLINE, Embase, and Cochrane Library.
  • Meta-analysis of pooled data to calculate risk ratios (RRs) for stroke in relation to COVID-19 severity.

Main Results:

  • In the multicenter study, 4.2% of hospitalized COVID-19 patients experienced stroke.
  • Pooled analysis of 741 patients showed an overall stroke rate of 2.9%.
  • Severe COVID-19 significantly increased the risk of acute stroke (RR = 4.18, P = 0.002).

Conclusions:

  • COVID-19 severity is a significant risk factor for acute stroke.
  • Findings highlight the importance of monitoring neurological complications in severe COVID-19 cases.
  • Further research may inform preventative strategies for stroke in high-risk COVID-19 patients.
Abstract

Keywords:
cerebrovascular diseases and cerebral circulationcohort studymeta-analysisrisk factorsstrokeviral infections

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