Overall, 1.4 percent of patients with COVID-19 have acute cerebrovascular disease, with acute ischemic stroke being the most common manifestation, according to a review published online Oct. 26 in the International Journal of Stroke.
Stefania Nannoni, M.D., Ph.D., from the University of Cambridge in the United Kingdom, and colleagues aimed to characterize the incidence and outcomes of COVID-19-associated stroke in a systematic review of three medical databases. Data from 61 studies were included in the meta-analysis.
The researchers found that acute cerebrovascular disease occurred in 1.4 percent of the 108,571 patients with COVID-19. The most common manifestation was acute ischemic stroke (87.4 percent), while intracerebral hemorrhage was less common (11.6 percent). Patients with COVID-19 developing acute cerebrovascular diseases were older than those who did not (pooled median difference, 4.8 years) and were more likely to have hypertension, diabetes mellitus, coronary artery disease, and severe infection (odds ratios, 7.35, 5.56, 3.12, and 5.10, respectively). Patients with COVID-19 and stroke were younger than those who experienced a stroke without the infection (pooled median difference, −6.0 years); they also had higher National Institutes of Health Stroke Scale scores (pooled median difference, 5), increased frequency of large-vessel occlusion (odds ratio, 2.73), and higher in-hospital mortality (odds ratio, 5.21).
“Clinicians will need to look out for signs and symptoms of stroke, particularly among those groups who are at particular risk, while bearing in mind that the profile of an at-risk patient is younger than might be expected,” a coauthor said in a statement.
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