COVID-19-Linked Ischemic Strokes More Severe

FRIDAY, Nov. 6, 2020 — COVID-19-associated ischemic strokes seem to be more severe and correlate with more severe disability on discharge and increased inpatient death, according to a study published online Nov. 5 in the Journal of Neurology, Neurosurgery & Psychiatry.

Richard J. Perry, Ph.D., B.M., B.Ch., from the UCL Hospitals NHS Foundation Trust in London, and colleagues conducted a case-control study involving patients admitted with stroke to 13 hospitals in England and Scotland from March 9 to July 5, 2020. Data were collected on 86 strokes (81 ischemic strokes, five intracerebral hemorrhages) in patients with evidence of COVID-19 at the time of stroke onset and 1,384 strokes (1,193 ischemic strokes, 191 intracerebral hemorrhages) in patients with no evidence of COVID-19.

The researchers found that ischemic strokes were more likely to occur in Asians in cases than controls (18.8 versus 6.7 percent). In cases, ischemic strokes were more likely to involve multiple large vessel occlusions (17.9 versus 8.1 percent), were more severe (National Institutes of Health Stroke Scale, 8 versus 5), and were associated with higher mean D-dimer levels (log₁₀, 3.4 versus 3.0 ng/ml); they also correlated with more severe disability on discharge (median modified Rankin scale, 4 versus 3) and inpatient death (19.8 versus 9.6 percent).

“These findings add substantially to the previous smaller and methodologically limited studies, summarized in a recent systematic review, to confirm that COVID-19 has an important influence over the onset, characteristics, and outcome of acute ischemic stroke,” the authors write.

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