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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Venous thromboembolism among Medicare acute ischaemic stroke patients with and without COVID-19

Xin Tong1, Quanhe Yang2, Ganesh Asaithambi3

  • 1Division for Heart Disease and Stroke Prevention, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA xtong@cdc.gov.

Stroke and Vascular Neurology
|November 15, 2022
PubMed

Insights

Patients with acute ischemic stroke (AIS) and a history of COVID-19 have a higher risk of venous thromboembolism (VTE). This increased VTE prevalence highlights the need for vigilant monitoring and prompt intervention in these vulnerable individuals.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Hematology

Background:

  • COVID-19 infection is linked to an elevated risk of venous thromboembolism (VTE).
  • Acute ischemic stroke (AIS) patients face a heightened risk of VTE.
  • The interplay between COVID-19 history and VTE risk in AIS patients requires further investigation.

Purpose of the Study:

  • To determine the prevalence of VTE in acute ischemic stroke (AIS) patients with and without a history of COVID-19.
  • To compare VTE rates between AIS patients with prior COVID-19 exposure and those without.
  • To quantify the association between COVID-19 history and VTE risk in AIS patients.

Main Methods:

  • Retrospective cohort study of Medicare fee-for-service (FFS) beneficiaries aged ≥65 years.
  • Inclusion of patients hospitalized for AIS between April 1, 2020, and March 31, 2022.
  • Comparison of VTE prevalence and adjusted prevalence ratios based on COVID-19 history.

Main Results:

  • VTE prevalence was 4.51% in AIS patients with hospitalised COVID-19, 2.96% with non-hospitalised COVID-19, and 2.61% in those without COVID-19.
  • AIS patients with a history of hospitalised COVID-19 had 1.62 times greater VTE prevalence compared to those without COVID-19.
  • AIS patients with a history of non-hospitalised COVID-19 had 1.13 times greater VTE prevalence compared to those without COVID-19.

Conclusions:

  • A significantly higher prevalence of VTE exists among Medicare beneficiaries with AIS and a history of COVID-19.
  • Early identification of coagulation abnormalities in these patients is crucial.
  • Prompt and appropriate interventions may improve clinical outcomes for AIS patients with COVID-19 history.
Abstract

Keywords:
COVID-19Risk FactorsStroke

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