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Increased Incidence of In-Hospital Ischemic Stroke During SARS-CoV-2 Outbreak: A Single-Center Study
Fernando Sierra-Hidalgo1, Esther Aragón Revilla2, Paz Arranz García3
1Department of Neurology, Hospital Universitario Infanta Leonor, Avenida Gran Vía del Este 80, 28031, Madrid, Spain. fernando.sierragh@salud.madrid.org.
Neurocritical Care
|July 16, 2021
Summary
The COVID-19 outbreak significantly increased the risk of in-hospital ischemic stroke (IHIS) in hospitalized patients. This rise may be due to the viral infection itself or hospital system strain during the pandemic.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Observational studies suggest a 1.1-1.7% stroke risk in hospitalized SARS-CoV-2 patients.
- Stroke consultations and reperfusion procedures decreased during early 2020.
- The precise stroke risk in coronavirus disease 2019 (COVID-19) patients remains unclear.
Purpose of the Study:
- To compare the incidence of in-hospital ischemic stroke (IHIS) in COVID-19 patients versus non-COVID-19 patients during the same period.
- To compare IHIS incidence in COVID-19 patients against historical non-COVID-19 patient cohorts.
Main Methods:
- A historical cohort study design was employed.
- Three patient groups were analyzed: COVID-19 cohort (CC), 2020 non-COVID-19 cohort (20NCC), and historical non-COVID-19 cohort (HNCC).
- Poisson regression was used to compare IHIS incidence rates.
Main Results:
- The absolute risk of IHIS was 0.36% in the CC, 0.23% in the 20NCC, and 0.05% in the HNCC.
- COVID-19 was an independent predictor of IHIS (IRR 6.76).
- A trend towards increased IHIS was observed in the 20NCC (IRR 5.62), though not statistically significant.
Conclusions:
- The SARS-CoV-2 outbreak correlated with a higher incidence of IHIS compared to historical controls.
- Both the viral infection and factors like hospital saturation likely contributed to the increased IHIS frequency.
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