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Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
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Clinical Characteristics of Stroke with COVID-19: A Systematic Review and Meta-Analysis

Mai Yamakawa1, Toshiki Kuno2, Takahisa Mikami3

  • 1Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|September 29, 2020
PubMed

Insights

COVID-19 patients had a 1.1% stroke frequency, often in older individuals with risk factors. This highlights a significant thromboembolism risk and high mortality in COVID-19 patients with stroke.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19) is linked to increased risks of thromboembolism and stroke.
  • Existing studies on COVID-19 patients with stroke show varied characteristics regarding demographics, comorbidities, treatments, and outcomes.

Purpose of the Study:

  • To determine the frequency and clinical characteristics of stroke in patients diagnosed with COVID-19.
  • To synthesize existing evidence on the association between COVID-19 and stroke.

Main Methods:

  • A systematic review and meta-analysis were conducted using data from PubMed and EMBASE up to June 10, 2020.
  • Included studies comprised retrospective cross-sectional studies, case series, and case reports, adhering to PRISMA guidelines.
  • One-group meta-analysis with a random-effects model was used to combine study-specific estimates.

Main Results:

  • 183 patients with COVID-19 and stroke were identified across 10 cohort studies and 16 case series/reports.
  • The frequency of stroke in hospitalized COVID-19 patients was 1.1% (95% CI: 0.6-1.6%).
  • The mean age of affected patients was 66.6 years, with 65.6% being male. Cryptogenic stroke was common (50.7%), and the case fatality rate was 44.2%.

Conclusions:

  • Stroke occurred in 1.1% of hospitalized COVID-19 patients, predominantly in older individuals with pre-existing stroke risk factors.
  • Elevated D-dimer levels and a high incidence of cryptogenic stroke suggest an increased risk of thromboembolism in COVID-19.
  • Further research is crucial to understand the pathophysiology and prognosis of stroke in COVID-19 to optimize patient care.
Abstract

Keywords:
COVID-19Meta-analysisSARS-CoV2Systematic reviewstroke

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