Evaluation of ischemic stroke patients associated with COVID-19

Abstract

Aims:Many neurological symptoms and complications, including stroke, may develop during Coronavirus disease-2019 (COVID-19). This study evaluated the risk, timing, prognosis, relationship between stroke and COVID-19, and treatment modalities of stroke due to COVID-19 by examining stroke patients with COVID-19.Methods:This retrospective cross-sectional study included 12 patients aged ≥18 years with acute ischemic stroke and who were hospitalized with a confirmed diagnosis of COVID-19. In this study, demographic findings, clinical and stroke symptoms, stroke time, comorbid conditions that could pose a risk for stroke, inflammatory markers, D-dimer levels, imaging results, cardiologic evaluations, O2 need, administered treatments, intensive care support, and prognosis were recorded retrospectively from patient files.Results:Of the patients, 50% were male and 50% were female. The mean age was 70.6±9.3 (range, 55-84) years. The most common comorbid conditions were hypertension (58.3%) and diabetes mellitus (41.7%). Stroke developed at a median of 10.5 [interquartile range (IQR), 5-19.5] days after symptoms COVID-19. The mean National Institutes of Health Stroke Scale score was 7.8±4.7 (range, 3-18) (1-25). The average D-dimer and IL-6 levels of the patients were measured as 3.7 (IQR, 2.7-7.6) mg/L and 44.1±41.2 (range, 4.0-117) pg/mL, respectively. Most patients (66.7%) required oxygen during their hospitalization.Conclusions:Patients with a stroke due to COVID-19 infection have several risk factors, particularly diabetes mellitus and hypertension. They had increased D-dimer levels, and most patients had severe disease. These results suggested that COVID-19 triggered or facilitated stroke rather than being an independent cause.

Keywords

• covid-19
• stroke
• risk factors
• comorbidities
• d-dimer