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Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry
Journal article   Open access   Peer reviewed

Stroke etiologies in patients with COVID-19: the SVIN COVID-19 multinational registry

María E Ramos-Araque, James E Siegler, Marc Ribo, Manuel Requena, Cristina López, Mercedes de Lera, Juan F Arenillas, Isabel Hernández Pérez, Beatriz Gómez-Vicente, Blanca Talavera, …
BMC neurology, Vol.21(1), pp.43-43
01/30/2021
DOI: 10.1186/s12883-021-02075-1
PMCID: PMC7846488
PMID: 33514335
url
https://doi.org/10.1186/s12883-021-02075-1View
Published (Version of record) Open Access

Abstract

Coronavirus disease 2019 (COVID-19) is associated with a small but clinically significant risk of stroke, the cause of which is frequently cryptogenic. In a large multinational cohort of consecutive COVID-19 patients with stroke, we evaluated clinical predictors of cryptogenic stroke, short-term functional outcomes and in-hospital mortality among patients according to stroke etiology. We explored clinical characteristics and short-term outcomes of consecutively evaluated patients 18 years of age or older with acute ischemic stroke (AIS) and laboratory-confirmed COVID-19 from 31 hospitals in 4 countries (3/1/20-6/16/20). Of the 14.483 laboratory-confirmed patients with COVID-19, 156 (1.1%) were diagnosed with AIS. Sixty-one (39.4%) were female, 84 (67.2%) white, and 88 (61.5%) were between 60 and 79 years of age. The most frequently reported etiology of AIS was cryptogenic (55/129, 42.6%), which was associated with significantly higher white blood cell count, c-reactive protein, and D-dimer levels than non-cryptogenic AIS patients (p</=0.05 for all comparisons). In a multivariable backward stepwise regression model estimating the odds of in-hospital mortality, cryptogenic stroke mechanism was associated with a fivefold greater odds in-hospital mortality than strokes due to any other mechanism (adjusted OR 5.16, 95%CI 1.41-18.87, p = 0.01). In that model, older age (aOR 2.05 per decade, 95%CI 1.35-3.11, p < 0.01) and higher baseline NIHSS (aOR 1.12, 95%CI 1.02-1.21, p = 0.01) were also independently predictive of mortality. Our findings suggest that cryptogenic stroke among COVID-19 patients carries a significant risk of early mortality.
 Magnetic Resonance Imaging Registries Stroke Adult Aged Aged, 80 and over Brain Ischemia Cohort Studies Computed Tomography Angiography COVID-19 - blood COVID-19 - complications COVID-19 - diagnostic imaging COVID-19 - mortality Egypt - epidemiology Female Fibrin Fibrinogen Degradation Products - metabolism Hospital Mortality Humans Ischemic Stroke - blood Ischemic Stroke - diagnostic imaging Ischemic Stroke - mortality Ischemic Stroke - virology Male Middle Aged Retrospective Studies Risk Factors SARS-CoV-2 Spain - epidemiology United States - epidemiology

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