COVID-19 Appears To Be Risk Factor for Ischemic Stroke

A new study presents data suggesting that COVID-19 is an independent risk factor for acute ischemic stroke.

The study, published in the American Journal of Neuroradiology, conducted the study to review evidence for a potential link between COVID-19 and acute stroke. They noted that “COVID-19 is an active worldwide pandemic with diverse complications,” but that stroke as a presentation has not been strongly associated with COVID-19.”

The retrospective case-control study of 42 cases (plus 82 controls) matched for age, sex, and risk factors. Patients in the study underwent stroke alert imaging between March 16 and April 5, 2020, at six centers in New York City. The control group consisted of patients who underwent imaging during the same time period with evidence of acute infarction. The researchers then performed a univariate analysis.

According to there data, the mean acute for cases and controls was 65.5 years and 68.8 years, respectively. The authors reported 46.3% of patients with acute ischemic stroke had COVID-19 vs. 18.3% for the controls (P=0.001). Following adjustment for age, sex, and risk factors, the authors reported that COVID-19 had a significant association with acute ischemic stroke (OR=3.9; 95% CI, 1.7 to 8.9; P=0.001).

“To our knowledge, this is the first study to link SARS-Cov-2 with increased risk of imaging confirmed acute ischemic stroke when accounting for confounding risk factors,” the researchers wrote in their conclusion. “Future endeavors may assess whether this relationship holds true in a larger population and with the pathophysiologic mechanisms (such as proinflammatory prothrombotic state and cytokine storm) inherent in COVID-19 that drive this association.”

They added: “Attempts should also be made to see whether the association holds true for large-vessel and small-vessel strokes. Patients with COVID-19 should be evaluated earliy for acute neurologic changes, and timely work-up should be performed in patients suspected of having stroke to reduce morbidity and mortality.”

Limitations included small sample side and others that “apply to all retrospective case-control studies,” the authors said.