A study published in Stroke reviewing nearly 28,000 emergency department records across 54 healthcare facilities has shown that less than 2% of patients diagnosed with COVID-19 suffered an acute ischaemic stroke. However, the study also found that those who did suffer an ischaemic stroke were at an increased risk of requiring long-term care after hospital discharge.
The study was conducted by researchers from the University of Missouri School of Medicine and MU Health Care. The researchers teamed up with the MU Institute for Data Science and Informatics and the Tiger Institute for Health Innovation to review data. These data are based on electronic medical encounters between December 2019 and April 2020. They found 103 patients (1.3%) developed ischaemic stroke among 8,163 patients with COVID-19. Comparatively, 199 patients (1%) developed ischaemic stroke among 19,513 patients who did not have COVID-19.
“Patients with COVID-19 who developed acute ischaemic stroke were older, more likely to be black and had a higher frequency of cardiovascular risk factors,” said lead researcher Adnan I Qureshi, professor of clinical neurology at the MU School of Medicine.
The mean age of COVID-19 patients with stroke was 68.8 compared with 54.4 for those without stroke. Among those with COVID-19 and stroke, 45% were Black, 36% were white and 6% were Hispanic. They tended to have hypertension (84%), high fat content in the blood (75%) and diabetes (56%).
“We also found that COVID-19 patients with stroke had a significantly higher rate of discharge to a destination other than home compared to stroke patients without COVID-19,” Qureshi said. “Patients with COVID-19 tend to have multisystem involvement and elevated markers of inflammation, which have been shown to increase the rate of death or disability.”
Qureshi said his findings are somewhat different from earlier studies that suggested patients with COVID-19 who developed stroke were younger and without pre–existing cardiovascular risk factors.
“Even if COVID-19 was a predisposing factor, the risk was mainly seen in those who were already at risk for stroke due to other cardiovascular risk factors,” Qureshi said.