[COVID-19 and stroke: associated or not ?]

Area of Science:

• Neurology
• Infectious Diseases
• Public Health

Background:

• COVID-19 patients exhibit an elevated risk of stroke.
• A worldwide decrease in stroke admissions occurred during the initial COVID-19 pandemic wave.
• SARS-CoV-2 infection impacts the endothelium and heart, promoting a procoagulant state.

Purpose of the Study:

• To explore the apparent contradiction between increased stroke risk in COVID-19 patients and reduced stroke admissions during the pandemic.
• To analyze the multifaceted impact of the pandemic on stroke incidence and hospital admissions.

Main Methods:

• Review of existing literature on COVID-19, stroke, and pandemic-related factors.
• Analysis of physiological effects of SARS-CoV-2 on the cerebrovascular system.
• Examination of population behavior and environmental changes during pandemic lockdowns.

Main Results:

• SARS-CoV-2 infection directly increases stroke risk through endothelial dysfunction and hypercoagulability.
• Population-level factors, including reduced emergency department contact and lower air pollution, influenced stroke admission rates.
• Conflicting trends in stroke risk and hospital admissions highlight the complex interplay of direct viral effects and indirect pandemic consequences.

Conclusions:

• The pandemic presents a complex scenario regarding stroke, with direct viral risks counterbalanced by indirect population and environmental effects.
• Understanding these dual impacts is crucial for managing stroke care during and after the COVID-19 pandemic.
• Further research is needed to fully elucidate the net effect of the pandemic on stroke epidemiology.