Ischemic stroke in 455 COVID-19 patients

Area of Science:

• Neurology
• Infectious Diseases
• Cardiology

Background:

• Growing evidence links COVID-19 to ischemic stroke (COVID-stroke).
• The exact frequency and underlying mechanisms of COVID-stroke are not fully understood.
• Understanding COVID-stroke is crucial for patient management and public health.

Purpose of the Study:

• To review and synthesize current literature on the frequency and pathogenesis of COVID-stroke.
• To analyze patient demographics, stroke characteristics, and clinical outcomes associated with COVID-stroke.
• To identify key risk factors and etiological factors contributing to COVID-stroke.

Main Methods:

• A narrative review of published literature.
• Inclusion of data from 455 patients with COVID-stroke.
• Synthesis of information on epidemiology, clinical presentation, and outcomes.

Main Results:

• COVID-stroke affects all age groups, with a predilection for males and anterior circulation.
• The majority of COVID-stroke cases are embolic, often associated with prevalent cardiovascular risk factors.
• COVID-19 symptoms may be mild or absent; strokes occur concurrently or up to 40 days post-pulmonary manifestation.
• While most patients recover partially or fully, approximately 25% experience fatal outcomes.

Conclusions:

• Ischemic stroke frequency has not increased due to the SARS-CoV-2 pandemic.
• COVID-stroke is primarily embolic, linked to cardiovascular risk factors rather than coagulopathy.
• Effective management requires considering cardiovascular risk and stroke etiology in COVID-19 patients.