COVID-19 and Stroke: Incidence and Etiological Description in a High-Volume Center

Manuel Requena, Marta Olivé-Gadea, Marian Muchada, Álvaro García-Tornel, Matías Deck, Jesús Juega, Sandra Boned, Noelia Rodríguez-Villatoro, Carlos Piñana, Jorge Pagola, David Rodríguez-Luna, David Hernández, Marta Rubiera, Alejandro Tomasello, Carlos A. Molina, Marc Ribo

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Background: An increased rate of thrombotic events has been associated to Coronavirus Disease 19 (COVID-19) with a variable rate of acute stroke. Our aim is to uncover the rate of acute stroke in COVID-19 patients and identify those cases in which a possible causative relationship could exist. Methods: We performed a single-center analysis of a prospective mandatory database. We studied all patients with confirmed COVID-19 and stroke diagnoses from March 2nd to April 30th. Demographic, clinical, and imaging data were prospectively collected. Final diagnosis was determined after full diagnostic work-up unless impossible due to death. Results: Of 2050 patients with confirmed SARS-CoV-2 infection, 21 (1.02%) presented an acute ischemic stroke 21 and 4 (0.2%) suffered an intracranial hemorrhage. After the diagnostic work-up, in 60.0% ischemic and all hemorrhagic strokes patients an etiology non-related with COVID-19 was identified. Only in 6 patients the stroke cause was considered possibly related to COVID-19, all of them required mechanical ventilation before stroke onset. Ten patients underwent endovascular treatment; compared with patients who underwent EVT in the same period, COVID-19 was an independent predictor of in-hospital mortality (50% versus 15%; Odds Ratio, 6.67; 95% CI, 1.1-40.4; p 0.04). Conclusions: The presence of acute stroke in patients with COVID-19 was below 2% and most of them previously presented established stroke risk factors. Without other potential cause, stroke was an uncommon complication and exclusive of patients with a severe pulmonary injury. The presence of COVID-19 in patients who underwent EVT was an independent predictor of in-hospital mortality.

Idioma originalAnglès
Número d’article105225
RevistaJournal of Stroke and Cerebrovascular Diseases
Volum29
Número11
DOIs
Estat de la publicacióPublicada - de nov. 2020
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