Cerebrovascular Accident and SARS-CoV-19 (COVID-19): A Systematic Review

Area of Science:

• Neurology
• Infectious Diseases
• Cardiovascular Science

Background:

• Neurologic symptoms like headache and anosmia are common in SARS-CoV-2 (COVID-19) patients.
• Emerging evidence indicates a link between COVID-19 infection and an increased risk of stroke (cerebrovascular accident - CVA).

Purpose of the Study:

• To investigate the association between COVID-19 infection and cerebrovascular accident (stroke).
• To analyze patient demographics, comorbidities, and COVID-19 severity in relation to stroke occurrence.

Main Methods:

• A systematic literature search was conducted across PubMed, MEDLINE, and CINAHL databases.
• Included studies were case series and case reports of patients with both COVID-19 and CVA from January 1 to September 1, 2020.
• Data collection, analysis, and risk of bias assessment were performed.

Main Results:

• The review identified 28 studies involving 73 patients diagnosed with both COVID-19 and CVA.
• The average age of hospitalized patients with COVID-19 and CVA was 60, with hypertension and diabetes being common comorbidities.
• Patients without pre-existing conditions were significantly younger (average age 47) and stroke risk was not solely dependent on COVID-19 severity.

Conclusions:

• SARS-CoV-2 may be an independent risk factor for stroke, particularly in individuals with hypertension and diabetes.
• The occurrence of stroke in younger, otherwise healthy COVID-19 patients warrants further investigation into SARS-CoV-2 as a direct cause.
• Additional research is crucial to elucidate the epidemiological factors and the hypercoagulable state associated with COVID-19 and stroke.