SNIS 2022: COVID-19 may increase stroke risk in younger patients and cause poorer outcomes

Pascal Jabbour

Stroke patients with COVID-19 are facing worse outcomes, and are often younger and healthier, according to research presented recently at the Society of NeuroInterventional Surgery’s (SNIS) 19th annual meeting (25–29 July, Toronto, Canada). People with COVID-19 are more than 2.5 times more likely to have an unfavourable outcome and face a difficult recovery post-stroke, the research also found.

A study entitled “Characteristics of a COVID-19 cohort with large vessel occlusion: a multicentre international study” reviewed data for 575 patients with acute large vessel occlusion (LVO)—including 194 who had COVID-19 and 381 who did not. These patients spanned nearly 50 thrombectomy-capable comprehensive stroke centres across Europe and North America. The control group was composed of patients who presented with LVO and received a mechanical thrombectomy between January 2018 and December 2020.

In the study, authors compared which patients had successful revascularisations following a thrombectomy procedure and left the hospital with little-to-no disabilities. Of the individuals with COVID-19, the severity of the virus on stroke onset was moderate in 75.5% of the cases, severe in 15.8% and critical in 8.7%. The mean duration between symptoms and stroke onset was about nine days, and 34% of the COVID-19 group had a stroke as their first symptom of the disease.

Researchers found that the patients with COVID-19 (who were younger and had fewer risk factors) were less likely to achieve successful revascularisation. In addition, the thrombectomy was prolonged in the COVID-19 group, as was the length of hospital stay. Mortality rates were more than twice as high in the COVID-19 group compared to controls.

Overall, COVID-19 was a predictor of poorer outcomes, even though many of the patients were younger, healthier and even had mild symptoms of the virus before the onset of stroke, the researchers concluded.

“There is still so much we need to learn about COVID-19, especially its impact on younger patients,” said Pascal Jabbour (Thomas Jefferson University, Philadelphia, USA), lead author of the study. “Stroke’s impact on individuals with COVID-19 is alarming and one we must continue to research and remedy.”

For more insight on the link between COVID-19 and stroke, and ongoing attempts to elucidate this relationship further—including Jabbour and colleagues’ recent study—read NeuroNews’ article featuring interviews with two physicians at the forefront of these research efforts.


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