Annals of Indian Academy of Neurology (Jan 2021)

Clinical features and outcome of stroke with COVID-19. COVID-19 Stroke Study Group (CSSG), India

  • Rohit Bhatia,
  • M V Padma Srivastava,
  • P N Sylaja,
  • Snigdha Komakula,
  • Ashish Upadhyay,
  • Vibhor Pardasani,
  • Thomas Iype,
  • Rajsrinivas Parthasarathy,
  • Rajshekhar Reddy,
  • Suman Kushwaha,
  • Jayanta Roy,
  • P Satish,
  • Anjan Trikha,
  • Naveet Wig,
  • Lalit Dhar,
  • Deepti Vibha,
  • Venugopalan Y Vishnu,
  • Awadh Kishore Pandit,
  • Anu Gupta,
  • A Elavarasi,
  • Ayush Agarwal,
  • Vipul Gupta,
  • Rakesh K Singh,
  • Harsh Oza,
  • Hiral Halani,
  • Dileep Ramachandran,
  • Githin B George,
  • Praveen Panicker,
  • M K Suresh,
  • S Kumaravelu,
  • Dheeraj Khurana,
  • Srijithesh P Rajendran,
  • Vijaya Pamidimukkala,
  • Salil Gupta,
  • Jeyaraj D Pandian,
  • Debashish Chowdhury,
  • Nirendra K Rai,
  • Arvind Sharma,
  • Vivek K Nambiar

DOI
https://doi.org/10.4103/aian.AIAN_122_21
Journal volume & issue
Vol. 24, no. 5
pp. 668 – 685

Abstract

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Background and Purpose: Occurrence of stroke has been reported among patients with COVID-19. The present study compares clinical features and outcomes of stroke patients with and without COVID-19. Methods: The COVID-19 Stroke Study Group (CSSG) is a multicentric study in 18 sites across India to observe and compare the clinical characteristics of patients with stroke admitted during the current pandemic period and a similar epoch in 2019. The present study reports patients of stroke with and without COVID-19 (CoVS and non-CoVS, respectively) seen between February 2020 and July 2020. Demographic, clinical, treatment, and outcome details of patients were collected. Results: The mean age and gender were comparable between the two groups. CoVS patients had higher stroke severity and extent of cerebral involvement on imaging. In-hospital complications and death were higher among CoVS patients (53.06% vs. 17.51%; P < 0.001) and (42.31% vs. 7.6%; P < 0.001), respectively. At 3 months, higher mortality was observed among CoVS patients (67.65% vs. 13.43%; P < 0.001) and good outcome (modified Rankin score [mRS]: 0–2) was seen more often in non-CoVS patients (68.86% vs. 33.33%; P < 0.001). The presence of COVID-19 and baseline stroke severity were independent predictors of mortality. Conclusions: CoVS is associated with higher severity, poor outcome, and increased mortality. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and baseline stroke severity are independent predictors of mortality.

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