The impact of SARS-CoV-2 infection on the outcome of acute ischemic stroke-A retrospective cohort study

• Published in: PloS one 2023-03, Vol.18 (3), p.e0282045-e0282045
• Main Authors: Takács, Tímea Tünde, Berki, Ádám József, Böjti, Péter Pál, Stang, Rita, Fritz-Reunes, Pablo Antonio, Schnekenberg, Luiz, Siepmann, Timo, Pintér, Alexandra, Szatmári, Szabolcs, Bereczki, Dániel, Gunda, Bence
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Cardiac arrhythmia; Cardiovascular disease; Cohort analysis; Comparative analysis; Coronaviruses; COVID-19; COVID-19 - complications; Diabetes; Health aspects; Humans; Hungary; Hypertension; Infections; Ischemia; Ischemic Stroke - complications; Laboratories; Lung diseases; Magnetic resonance imaging; Medicine and Health Sciences; Mortality; Occlusion; Patient outcomes; Patients; Pneumonia; Prognosis; Regression analysis; Respiratory diseases; Retrospective Studies; Risk factors; SARS-CoV-2; Severe acute respiratory syndrome; Severe acute respiratory syndrome coronavirus 2; Statistics; Stroke; Stroke (Disease); Stroke - complications; Transient ischemic attack; Viral diseases
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0282045

Acute ischemic stroke (AIS) is a common complication of severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection (COVID-19), but the prognosis of these patients is poorly understood. To explore the impact of COVID-19 on neurological outcomes in AIS patients. A comparative retrospective cohort study was conducted in 32 consecutive AIS patients with and 51 without COVID-19 between the 1st of March 2020 and 1st of May 2021. The evaluation was based on a detailed chart review for demographic data, medical history, stroke severity, cranial and vessel imaging results, laboratory parameters, COVID-19 severity, hospitalization time, in-hospital mortality, and functional deficits at discharge (modified Rankin Scale, mRS). COVID-19 AIS patients showed tendency to worse initial neurological deficit (NIHSS 9 (3-13) vs. 4 (2-10); p = 0.06), higher rate of large vessel occlusion (LVO; 13/32 vs. 14/51; p = 0.21), had prolonged hospitalization (19.4 ± 17.7 vs. 9.7 ± 7 days; p = 0.003), had lower chance of functional independence (mRS≤2) (12/32 vs. 32/51; p = 0.02) and showed higher in-hospital mortality (10/32 vs. 6/51; p = 0.02). In COVID-19 AIS patients, LVO was more common with COVID-19 pneumonia than without (55.6% vs. 23.1%; p = 0.139). COVID-19-related AIS carries a worse prognosis. COVID-19 with pneumonia seems to be associated with a higher rate of LVO.