COVID-Related Strokes Especially Severe, Result in Worse Out
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Ischemic strokes in COVID-19 patients tended to be more severe than those in other individuals, according to a case-control study from the U.K.

Among 86 stroke patients with COVID-19, stroke characteristics and outcomes differed from uninfected stroke patients treated during the same period. The COVID-19-associated strokes:

-- Were more likely to involve multiple large vessel occlusions (17.9% vs 8.1%)
-- Were more severe (median NIH Stroke Scale score 8 vs 5)
-- Were associated with higher D-dimer levels (3.4 vs 3.0 ng/ml on the log10 scale)
-- Resulted in more severe disability on discharge (median modified Rankin Scale score 4 vs 3)
-- Resulted in more deaths during index admission (19.8% vs 9.6%)

"This study provides the most compelling evidence yet that COVID-19-associated ischaemic strokes are more severe and more likely to result in severe disability or death, although the outlook is not quite as bleak as previous studies have suggested," according to authors.

A median of 6 days elapsed from onset of COVID-19 symptoms to the onset of ischemic stroke among patients admitted to 13 centers in England and Scotland.

Large vessel occlusion in COVID-19 may be a direct manifestation of a SARS-CoV-2-related hypercoagulable state -- as suggested by elevated D-dimers -- but levels of the biomarker varied substantially, suggesting much heterogeneity among patients, researchers indicated.

Source: https://jnnp.bmj.com/content/early/2020/11/03/jnnp-2020-324927
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