Acute Cerebrovascular Events With COVID-19 Infection
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COVID-19 has been associated with an increased incidence of thrombotic events, including stroke. However, characteristics and outcomes of COVID-19 patients with stroke are not well known.

Researchers conducted a retrospective observational study of risk factors, stroke characteristics, and short-term outcomes in a large health system in New York City. They included consecutively admitted patients with acute cerebrovascular events from March 1, 2020 through April 30, 2020. Data were stratified by COVID-19 status, and demographic variables, medical comorbidities, stroke characteristics, imaging results, and in-hospital outcomes were examined. Among COVID-19-positive patients, we also summarized laboratory test results.

-- Of 277 patients with stroke, 105 (38.0%) were COVID-19-positive.

-- Compared with COVID-19-negative patients, COVID-19-positive patients were more likely to have a cryptogenic (51.8% versus 22.3%) stroke cause and were more likely to suffer ischemic stroke in the temporal, parietal, occipital, and cerebellar regions.

-- In COVID-19-positive patients, mean coagulation markers were slightly elevated (prothrombin time 15.4±3.6 seconds, partial thromboplastin time 38.6±24.5 seconds, and international normalized ratio 1.4±1.3).

-- Outcomes were worse among COVID-19-positive patients, including longer length of stay, greater percentage requiring intensive care unit care, and greater rate of neurological worsening during admission; additionally, more COVID-19-positive patients suffered in-hospital death (33% versus 12.9%).

Conclusively, baseline characteristics in patients with stroke were similar comparing those with and without COVID-19. However, COVID-19-positive patients were more likely to experience stroke in a lobar location, more commonly had a cryptogenic cause, and had worse outcomes.