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COVID-19 and Stroke: Incidence and Etiological Description in a High-Volume Center

Manuel Requena1, Marta Olivé-Gadea2, Marian Muchada3

  • 1Stroke Unit, Neurology Department, Vall d'Hebron University Hospital, Barcelona 119-129, Spain.; Departament de Medicina, Universitat Autónoma de Barcelona, Barcelona, Spain; Stroke Research Group, Vall d'Hebron Research Institute, Barcelona, Spain.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 17, 2020
PubMed

Insights

The rate of acute stroke in Coronavirus Disease 19 (COVID-19) patients is below 2%. Stroke was uncommon in COVID-19 patients, primarily occurring in those with severe lung injury and pre-existing risk factors.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus Disease 19 (COVID-19) is associated with an increased risk of thrombotic events.
  • The precise incidence and causality of acute stroke in COVID-19 patients remain under investigation.

Purpose of the Study:

  • To determine the incidence of acute stroke in patients diagnosed with COVID-19.
  • To identify potential causative links between COVID-19 and stroke events.

Main Methods:

  • A single-center analysis of a prospective database included patients with confirmed COVID-19 and stroke.
  • Demographic, clinical, and imaging data were collected for diagnosis.
  • Etiology was determined through comprehensive diagnostic work-up.

Main Results:

  • 1.02% of COVID-19 patients experienced acute ischemic stroke, and 0.2% had intracranial hemorrhage.
  • In most cases (60% ischemic, 100% hemorrhagic), stroke etiology was unrelated to COVID-19.
  • Only 6 patients had strokes possibly related to COVID-19, all requiring mechanical ventilation; COVID-19 was an independent predictor of mortality in patients undergoing endovascular treatment.

Conclusions:

  • Acute stroke is an uncommon complication of COVID-19, occurring in less than 2% of cases.
  • Most strokes in COVID-19 patients had established risk factors or were unrelated to the infection.
  • COVID-19 was an independent predictor of in-hospital mortality for patients who underwent endovascular treatment for stroke.
Abstract

Keywords:
Acute strokeCOVID-19Critical carePandemic

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