Cardioembolic stroke, the most common subtype of stroke in COVID 19: A single center experience from Isfahan, Iran
Marzieh Tajmirriahi1, Maryam Masjedi Esfahani1, Zahra Amouaghaei1
1Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Stroke is an uncommon complication of coronavirus disease 2019 (COVID-19). Cardioembolic stroke was the most frequent subtype observed in Iranian patients, often presenting as an initial symptom.
Area of Science:
- Neurology
- Infectious Diseases
- Public Health
Background:
- Cerebrovascular manifestations, including stroke, have been reported in patients with coronavirus disease 2019 (COVID-19).
- Limited data exist on the specific stroke subtypes occurring in COVID-19 patients.
- This study investigates stroke subtypes in COVID-19 patients in Isfahan, Iran.
Purpose of the Study:
- To determine the incidence and types of stroke in hospitalized patients with confirmed coronavirus disease 2019 (COVID-19).
- To characterize the stroke subtypes and their association with COVID-19 severity and presentation.
Main Methods:
- A retrospective, observational case series was conducted.
- Data were collected from 1188 consecutive hospitalized patients with laboratory-confirmed COVID-19 between March 1, 2020, and May 20, 2020.
- Stroke subtypes, clinical presentation, and COVID-19 severity were analyzed.
Main Results:
- Seven out of 1188 (0.5%) COVID-19 patients experienced stroke.
- The stroke subtypes included ischemic arterial stroke (n=5), hemorrhagic stroke (n=1), and cerebral venous and sinus thrombosis (n=1).
- Cardioembolic stroke constituted 60% of ischemic strokes; 40% were of undetermined source. Stroke presented as an initial symptom in 40% of cases, and 57% had severe COVID-19.
Conclusions:
- Stroke is an infrequent but significant cerebrovascular complication of COVID-19.
- Cardioembolic stroke is a common subtype among COVID-19 patients requiring hospitalization.
- Early recognition of stroke as a potential COVID-19 manifestation is crucial.
Background:
Some studies showed the cerebrovascular manifestation in patients with recently pandemic coronavirus 2 named the coronavirus disease 2019 (COVID-19). However, there are rare reports about stroke subtypes in these patients. Here, we reported the stroke subtype in patients with laboratory-confirmed diagnosis of COVID-19 and treated at our hospitals, which are located in Isfahan, Iran.
Materials And Methods:
This is a retrospective, observational case series. Data were collected from March 01, 2020, to May 20, 2020, at three designated special care centers for COVID-19 of Isfahan University of Medical Sciences. The study included 1188 consecutive hospitalized patients with laboratory-confirmed diagnosis of COVID-19.
Results:
Of 1188 COVID-19 patients, 7 (0.5%) patients developed stroke. Five (0.4%) had ischemic arterial stroke, 1 (0.08%) hemorrhagic stroke and 1(0.08 %) cerebral venous and sinus thrombosis. Sixty percent of ischemic stroke were cardioembolic stroke (CE) and the rest 2 (40%) were embolic stroke of undetermined source. Three male patients (40%) had stroke as a presenting and admitted symptom of COVID-19. Four patients (57%) had severe COVID-19.
Conclusion:
Stroke was an uncommon manifestation in COVID-19 patients. CE was a common subtype of stroke in COVID-19 patients in our centers.
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