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Published on: August 11, 2023
Acute Ischemic Stroke and COVID-19: An Analysis of 27 676 Patients
Adnan I Qureshi1,2, William I Baskett3, Wei Huang1,2
1Zeenat Qureshi Institute, St Cloud, MN (A.I.Q, W.H., I.L.).
Insights
Acute ischemic stroke is infrequent in COVID-19 patients but associated with higher risks. Patients with coronavirus disease 2019 and stroke faced double the risk of adverse outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Cardiology
Background:
- Coronavirus disease 2019 (COVID-19) is linked to acute ischemic stroke.
- Risk factors, in-hospital events, and outcomes require further study in large COVID-19 cohorts.
Purpose of the Study:
- Identify risk factors, comorbidities, and outcomes in COVID-19 patients with acute ischemic stroke.
- Compare outcomes between COVID-19 patients with and without stroke, and with non-COVID-19 stroke patients.
Main Methods:
- Analysis of the Cerner deidentified COVID-19 dataset from 54 healthcare facilities.
- Inclusion of patients with emergency department or inpatient encounters for COVID-19 (suspected, exposed, or confirmed).
Main Results:
- 1.3% of COVID-19 patients (103/8163) developed acute ischemic stroke.
- COVID-19 patients with stroke had higher rates of hypertension, diabetes, hyperlipidemia, atrial fibrillation, and congestive heart failure.
- Acute ischemic stroke in COVID-19 patients was associated with a 2-fold increased risk of adverse outcomes (discharge other than home or death).
- 1.0% of non-COVID-19 patients (199/19513) developed acute ischemic stroke.
- COVID-19 was associated with a 1.2-fold increased risk of adverse outcomes in ischemic stroke patients.
Conclusions:
- Acute ischemic stroke is infrequent in COVID-19 patients, often co-occurring with cardiovascular risk factors.
- The occurrence of acute ischemic stroke significantly increases the risk of adverse outcomes in COVID-19 patients.
Background And Purpose:
Acute ischemic stroke may occur in patients with coronavirus disease 2019 (COVID-19), but risk factors, in-hospital events, and outcomes are not well studied in large cohorts. We identified risk factors, comorbidities, and outcomes in patients with COVID-19 with or without acute ischemic stroke and compared with patients without COVID-19 and acute ischemic stroke.
Methods:
We analyzed the data from 54 health care facilities using the Cerner deidentified COVID-19 dataset. The dataset included patients with an emergency department or inpatient encounter with discharge diagnoses codes that could be associated to suspicion of or exposure to COVID-19 or confirmed COVID-19.
Results:
A total of 103 (1.3%) patients developed acute ischemic stroke among 8163 patients with COVID-19. Among all patients with COVID-19, the proportion of patients with hypertension, diabetes, hyperlipidemia, atrial fibrillation, and congestive heart failure was significantly higher among those with acute ischemic stroke. Acute ischemic stroke was associated with discharge to destination other than home or death (relative risk, 2.1 [95% CI, 1.6-2.4]; P<0.0001) after adjusting for potential confounders. A total of 199 (1.0%) patients developed acute ischemic stroke among 19 513 patients without COVID-19. Among all ischemic stroke patients, COVID-19 was associated with discharge to destination other than home or death (relative risk, 1.2 [95% CI, 1.0-1.3]; P=0.03) after adjusting for potential confounders.
Conclusions:
Acute ischemic stroke was infrequent in patients with COVID-19 and usually occurs in the presence of other cardiovascular risk factors. The risk of discharge to destination other than home or death increased 2-fold with occurrence of acute ischemic stroke in patients with COVID-19.
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