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The relationship between COVID-19's severity and ischemic stroke: a systematic review and meta-analysis

Yue Lu1, Jie-Ji Zhao1, Meng-Fan Ye1

  • 1Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China.

Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
|May 6, 2021
PubMed

Insights

Severe coronavirus disease 2019 (COVID-19) significantly increases the risk of acute ischemic stroke. This finding highlights the critical need for vigilant monitoring and management of stroke risk in severe COVID-19 patients.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • Coronavirus disease 2019 (COVID-19) is a global health crisis.
  • Neurological complications, including ischemic stroke, have been reported in COVID-19 patients.
  • The association between COVID-19 severity and ischemic stroke risk requires further clarification.

Purpose of the Study:

  • To determine the risk of acute ischemic stroke in patients with severe versus non-severe coronavirus disease 2019 (COVID-19).
  • To quantify the association between COVID-19 severity and acute ischemic stroke through a meta-analysis.

Main Methods:

  • A comprehensive literature search was performed across major scientific databases (PubMed, Embase, Web of Science, Cochrane Library) until October 28, 2020.
  • Studies reporting COVID-19 severity classification and acute ischemic stroke incidence were included.
  • Risk ratios (RR) and 95% confidence intervals (CI) were calculated using a random-effects model.

Main Results:

  • Eight studies involving 5266 patients were analyzed.
  • The overall incidence of ischemic stroke among COVID-19 patients was 1.76%.
  • Severe COVID-19 patients exhibited a significantly higher risk of acute ischemic stroke (RR = 3.53, 95% CI: 2.06-6.07) compared to non-severe cases.

Conclusions:

  • Severe COVID-19 is significantly associated with an elevated risk of acute ischemic stroke.
  • This association remains consistent regardless of the specific clinical parameters used to define COVID-19 severity.
  • The findings underscore the importance of considering stroke risk in the management of severe COVID-19.
Abstract

Keywords:
COVID-19Ischemic strokeMeta-analysisSeverity

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