Characteristics of COVID-19 Related Stroke: A Single-center Prospective Study

Abstract

Objective:Coronavirus disease-2019 (COVID-19) seems more related to stroke than other respiratory viruses. Acute stroke has become increasingly conspicuous during a typical COVID-19 infection. In the present study, we aim to evaluate stroke characteristics in the context of COVID-19 infection.Method:We conducted a single-center prospective study and evaluated characteristics of stroke patients who had concomitant definite COVID-19 (dCOV) (n=24), suspected COVID-19 (sCOV) (n=31), and no COVID-19 (CG) (n=19). Then we classified all participants into two groups according to the modified Rankin scale (mRS) scores (0-2 indicating good outcome, 3-6 indicating poor outcome). A logistic regression analysis and a receiver operating characteristic area under the curve were performed to evaluate the variables, which predict a poor prognosis.Results:Just over half of the patients in the dCOV were admitted with stroke symptoms and diagnosed with COVID-19 at admission, and nearly half of the patients initially had a COVID-19 diagnosis. They had developed stroke after a gap of 4-21 days. Ischemic stroke was the most common stroke subtype in dCOV. The dCOV had higher mRS indicating poor outcomes. Patients with poor outcomes had higher levels of D-dimer, neutrophil-to-lymphocyte ratio (NLR), procalcitonin, and aspartate aminotransferase. NLR reliably predicts poor outcome, overall with an accuracy of 86%.Conclusion:COVID-19 related stroke is associated with high inflammatory biomarkers, poor outcome, and high mortality. NLR is a potential, cost-effective, and easy-to-use marker for poor prognosis in COVID-19 related stroke.

Keywords

• cerebrovascular disease
• covid-19
• neutrophil-tolymphocyte ratio
• prognosis
• stroke