Frontiers in Neurology (Jul 2022)

Association Between Previous Stroke and Severe COVID-19: A Retrospective Cohort Study and an Overall Review of Meta-Analysis

  • Huayao Huang,
  • Junnian Chen,
  • Shuangfang Fang,
  • Xiaoling Chen,
  • Xiaobin Pan,
  • Hanhan Lei,
  • Yixian Zhang,
  • Hailong Lin,
  • Qilin Yuan,
  • Pincang Xia,
  • Nan Liu,
  • Nan Liu,
  • Houwei Du

DOI
https://doi.org/10.3389/fneur.2022.922936
Journal volume & issue
Vol. 13

Abstract

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ObjectiveThe objective of this study was to investigate the association between previous stroke and the risk of severe coronavirus disease 2019 (COVID-19).MethodsWe included 164 (61.8 ± 13.6 years) patients with COVID-19 in a retrospective study. We evaluated the unadjusted and adjusted associations between previous stroke and severe COVID-19, using a Cox regression model. We conducted an overall review of systematic review and meta-analysis to investigate the relationship of previous stroke with the unfavorable COVID-19 outcomes.ResultsThe rate of severe COVID-19 in patients with previous stroke was 28.37 per 1,000 patient days (95% confidence interval [CI]: 10.65–75.59), compared to 3.94 per 1,000 patient days (95% CI: 2.66–5.82) in those without previous stroke (p < 0.001). Previous stroke was significantly associated with severe COVID-19 using a Cox regression model (unadjusted [hazard ratio, HR]: 6.98, 95% CI: 2.42–20.16, p < 0.001; adjusted HR [per additional 10 years]: 4.62, 95% CI: 1.52–14.04, p = 0.007). An overall review of systematic review and meta-analysis showed that previous stroke was significantly associated with severe COVID-19, mortality, need for intensive care unit admission, use of mechanical ventilation, and an unfavorable composite outcome.ConclusionPrevious stroke seems to influence the course of COVID-19 infection; such patients are at high risk of severe COVID-19 and might benefit from early hospital treatment measures and preventive strategies.

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