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Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry

María E Ramos-Araque1,2, James E Siegler3, Marc Ribo4,5

  • 1Institute of Biomedical Research of Salamanca, Department of Neurology, Hospital Universitario de Salamanca, Salamanca, Spain.

BMC Neurology
|January 30, 2021
PubMed

Insights

Cryptogenic stroke in COVID-19 patients is common and linked to higher mortality. This study identifies predictors of cryptogenic stroke and its association with increased in-hospital death risk.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19) presents a notable risk for stroke, often cryptogenic.
  • Understanding stroke etiology in COVID-19 patients is crucial for predicting outcomes.

Purpose of the Study:

  • To evaluate clinical predictors of cryptogenic stroke in COVID-19 patients.
  • To assess short-term functional outcomes and in-hospital mortality based on stroke etiology in a large multinational cohort.

Main Methods:

  • A multinational cohort study included 14,483 laboratory-confirmed COVID-19 patients with acute ischemic stroke (AIS) from 31 hospitals.
  • Clinical characteristics, stroke etiology, and in-hospital outcomes were analyzed for patients aged 18 years or older.

Main Results:

  • 1.1% of COVID-19 patients (156/14,483) had AIS. Cryptogenic stroke (42.6%) was the most frequent etiology.
  • Cryptogenic AIS was associated with higher white blood cell count, C-reactive protein, and D-dimer levels.
  • Cryptogenic stroke mechanism independently predicted a fivefold increase in in-hospital mortality (aOR 5.16), alongside older age and higher NIHSS.

Conclusions:

  • Cryptogenic stroke in COVID-19 patients is associated with a significant risk of early mortality.
  • Identifying cryptogenic stroke mechanisms is vital for managing COVID-19 patients at risk of stroke.
Abstract

Keywords:
COVID-19CoronavirusCryptogenicMortalityStroke

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