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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.
Insights
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.
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.
Objectives:
To assess whether COVID-19 could be a concurrent factor in the genesis and/or worsening of stroke and to provide data on COVID-19 -associated stroke patients during the first pandemic wave and comparative data on COVID-19 negative stroke patients in the same period.
Materials And Methods:
This is a retrospective, observational, case-control, single centre study, carried out in a General Hospital in northern Italy. Sixty-three consecutive stroke patients were included, COVID-19-associated stroke was classified as cases and non COVID-19-associated stroke as controls.
Results:
A total of 19/63 (28.8%) had a COVID-19-associated stroke, 11 /63 (17.5%) were haemorrhagic and 52/63 (82.5%) ischaemic. COVID-19-associated strokes were more severe (p-value 0.019) and had a higher risk of severe disability and/or death (OR 3.79, CI 95%: 1.21-11.93, p-value 0.19). The COVID-19-associated stroke patients with onset during hospitalization for COVID-19 had a more severe stroke than patients with COVID-19 onset during hospitalization for stroke (p-value 0.019).
Conclusion:
Although no relationship was observed between the stroke aetiology and COVID-19, intriguingly, COVID-associated stroke turned out to be more severe and disabling. Hopefully, further studies will provide more data and help in the management of this emerging population.
