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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Coronavirus Disease 2019 in Patients With Prior Ischemic Stroke

Krishna Nalleballe1, Suman Siddamreddy2, Sen Sheng1

  • 1Neurology, University of Arkansas for Medical Sciences, Little Rock, USA.

Cureus
|October 12, 2020
PubMed

Insights

Patients with a history of ischemic stroke are more vulnerable to coronavirus disease 2019 (COVID-19) complications, including higher hospitalization and critical care needs. This highlights stroke survivors as a vulnerable population requiring specific attention during the COVID-19 pandemic.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Uncertainty exists regarding the vulnerability of patients with prior ischemic stroke to coronavirus disease 2019 (COVID-19).
  • Ischemic stroke survivors may face increased risks for severe COVID-19 outcomes.

Purpose of the Study:

  • To investigate the association between a history of ischemic stroke and COVID-19 outcomes.
  • To identify if prior ischemic stroke increases vulnerability to COVID-19 complications.

Main Methods:

  • Utilized the TriNetX global health collaborative research platform and its COVID-19 database.
  • Identified COVID-19 cases via positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lab tests.
  • Employed propensity score matching to compare outcomes between patients with and without a history of ischemic stroke.

Main Results:

  • Patients with prior ischemic stroke were older and had more comorbidities.
  • After propensity matching, statistically significant increases in hospitalization (p=0.0035) and critical care needs (p=0.0082) were observed in the ischemic stroke cohort.
  • Trends towards higher rates of intubation and death were noted but did not reach statistical significance.

Conclusions:

  • Patients with a history of ischemic stroke represent a vulnerable population for COVID-19.
  • Older age and comorbidities contribute to worse clinical outcomes post-COVID-19 in this group.
  • Further research may be warranted to explore specific interventions for this high-risk group.
Abstract

Keywords:
covid 19stroke

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