An international team of researchers has found that acute ischemic stroke (AIS) linked to Covid-19 are more severe, lead to worse functional outcomes and are associated with higher mortality.
For the study, published in Stroke: Journal of the American Heart Association, the researchers analysed data on patients with Covid-19 and AIS treated at 28 healthcare centres in 16 countries this year.
They compared them to patients without Covid-19 from the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) Registry, from 2003 to 2019.
The research team sought to determine the clinical characteristics and outcomes of patients with Covid-19 and AIS.
According to the study, between January 27 to May 19 this year, there were 174 patients hospitalised with Covid-19 and AIS.Each Covid-19 patient with AIS was matched and compared to a non-Covid-19 AIS patient based on a set of pre-specified factors including age, gender and stroke risk factors.
The final analysis included 330 patients in total.In both patient groups, stroke severity was estimated with the National Institute of Health Stroke Scale (NIHSS), and stroke outcome was assessed by the modified Rankin score (mRS).
When AIS patients with Covid-19 were compared to non-COVID-19 patients, the study found that patients suffering from novel coronavirus had more severe strokes.
The findings also showed that Covid-19 patients had a higher risk for a severe disability following stroke and Covid-19 patients were more likely to die of AIS.
The researchers noted there are several potential explanations for the relationship between Covid-19-associated strokes and increased stroke severity:The increased stroke severity at admission in COVID-19-associated stroke patients compared to the non-COVID-19 cohort may explain the worse outcomes, the researchers said.
The broad, multi-system complications of Covid-19, including acute respiratory distress syndrome, cardiac arrhythmias, acute cardiac injury, shock, pulmonary embolism, cytokine release syndrome and secondary infection, probably contribute further to the worse outcomes including higher mortality in these patients.
"The association highlights the urgent need for studies aiming to uncover the underlying mechanisms and is relevant for prehospital stroke awareness and in-hospital acute stroke pathways during the current and future pandemics," the study authors wrote.
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