A recently published study has shown fewer people than previously reported have had strokes as a result of COVID-19; however, strokes that accompany the novel coronavirus appear to be more severe. The analysis by Shadi Yaghi and colleagues from New York University School of Medicine, New York, USA, was published online ahead of print in Stroke.
The study found that, of the 3,556 hospitalised patients with a diagnosis of COVID-19, less than 1% (32 patients) had a stroke. This, according to the authors, contrasts with the rates reported recently in small studies in China and Italy, which ranged from 2% to 5%.
However, the investigation also demonstrated that patients with both conditions were younger, had worse symptoms, and were at least seven times more likely to die than stroke victims who were not infected. “When compared with contemporary controls, COVID-19 positive patients had higher admission National Institutes of Health Stroke Scale score and higher peak D-dimer levels,” the authors write, adding that when compared to historical controls, COVID-19 positive patients were also more likely to be younger men with elevated troponin, higher NIHSS scores, and higher erythrocyte sedimentation rates.
Additionally, Yaghi and his team reported that patients with COVID-19 and stroke had significantly higher mortality than both historical and contemporary controls. During the study period, 63% died, compared with 9% for those without the virus and 5% of pracademic stroke patients.
The investigators conducted a retrospective cohort study with ischaemic stroke patients who were hospitalised between March 15, 2020, and April 19, 2020. Through the use of medical records, clinical characteristics of stroke patients with a concurrent diagnosis of COVID-19 were compared to patients without the disease (contemporary controls), and to a cohort of patients with stroke already discharged (historical controls).
“Our findings provide compelling evidence that widespread blood clotting may be an important factor that is leading to stroke in patients with COVID-19. The results point to anticoagulant, or blood thinner therapy, as a potential means of reducing the unusual severity of strokes in people with the coronavirus,” states the study’s senior investigator, Jennifer Frontera, in NYU Langone press release.
Yaghi also highlighted that the study is the largest of its kind among COVID-19 stroke victims and adds valuable insight into the poorly understood complications of COVID-19 disease. He commented, “Our study suggests that stroke is an uncommon yet important complication of coronavirus given that these strokes are more severe when compared with strokes occurring in patients who tested negative for the virus.”
In addition to investigating anticoagulant therapy, Frontera and Yaghi plan to continue the study to confirm if the findings are sustained through the end of the year.