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A "Post-mortem" of COVID-19-associated stroke: a case-control study.

Paolo Immovilli1, Elena Marchesi1, Chiara Terracciano1

  • 1Ospedale Guglielmo da Saliceto, Piacenza, Italy.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|September 10, 2022
PubMed
Summary

COVID-19 (Coronavirus Disease 2019) associated strokes were found to be more severe and disabling than non-COVID-19 strokes. Further research is needed to understand and manage this emerging patient population.

Keywords:
COVID-19COVID-19-associated strokeCase-control studyLarge vessel occlusionSARS-CoV-2

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Public Health

Background:

  • The first wave of the COVID-19 pandemic presented unique challenges to healthcare systems globally.
  • Understanding the concurrent impact of COVID-19 on cerebrovascular events is crucial for patient management.
  • Stroke remains a leading cause of death and disability worldwide.

Purpose of the Study:

  • To investigate COVID-19 as a potential factor in stroke development and severity.
  • To gather data on patients experiencing stroke concurrently with COVID-19 during the initial pandemic wave.
  • To compare outcomes of COVID-19-associated stroke with non-COVID-19 stroke cases.

Main Methods:

  • A retrospective, observational, case-control study was conducted at a single center in northern Italy.
  • Sixty-three consecutive stroke patients were analyzed.
  • COVID-19-associated stroke patients were categorized as cases, and COVID-19-negative stroke patients served as controls.

Main Results:

  • Out of 63 stroke patients, 19 (28.8%) had COVID-19-associated strokes.
  • COVID-19-associated strokes exhibited greater severity (p=0.019) and a higher risk of severe disability or death (OR 3.79).
  • Strokes in patients hospitalized for COVID-19 were more severe than in those hospitalized for stroke with subsequent COVID-19 diagnosis (p=0.019).

Conclusions:

  • No direct link between stroke etiology and COVID-19 was established.
  • COVID-19-associated strokes were significantly more severe and disabling.
  • Further research is warranted to elucidate the mechanisms and guide the management of COVID-19-related stroke.